一期切开复位钢板螺钉内固定治疗胫腓骨中下段粉碎性骨折疗效分析

Surgical treatment with plate and screws as early as possible for middle and distal tibial and fibular comminuted fracture

目的总结伤后一期切开复位钢板螺钉内固定治疗胫腓骨中下段粉碎性骨折的临床效果。方法采用一期切开复位、使用不同类型AO接骨板(包括DCP4.5、LC-DCP4.5、PC-Fix和LISS)内固定治疗73例胫腓骨中下段粉碎性骨折,根据AOFAS踝关节功能评分标准评价临床治疗效果。结果随访6个月～3.5年,闭合性骨折40例,33例评分(94.0±3.7)分,5例(78.0±1.4)分;开放型骨折33例,21例(93.0±2.6)分,8例(77.0±1.8)分;优良率达91.8%。结论一期切开复位钢板螺钉内固定是胫腓骨中下段粉碎性骨折切实可行的治疗方法,可使患肢早期功能恢复,避免骨筋膜间室综合征的发生。

Objective To evaluate the surgical treatment with plate and screws for middle and distal tibial and fibular comminuted fracture. Methods 73 cases with middle and distal tibial and fibular comminution fracture were treated with internal fixation using different plates supplied by AO company as early as possible. The curative effects were evaluated by AOFAS. Results All cases were followed up for 6 months to 3.5 years with average of 21 months. In 40 cases of closed fracture, there were 33 cases with average score of 94.0±3.7 and 5 cases with average score of 78.0±1.4. In 33 cases of open fracture, there were 21 cases with average score of 93.0±2.6 and 8 cases with average score of 77.0±1.8. According to AOFAS, the rate of the good function of ankle was 91.8%. Conclusions The curative effect of internal fixation with plate and screws is satisfied and clinically feasible for the middle and distal tibial and fibular comminuted fracture, which may recover the function of affected limb as early as possible and prevent the complications of comportment syndrome.