严重胫骨开放性骨折的分期处理和应用锁定钢板的效果分析

Staged Management of Severe Tibia Open Fractures and to Analyze the Effects of the Locking Compression Plate

目的探讨严重胫骨开放骨折的分期处理方法,并对锁定钢板在其治疗中的疗效进行分析。方法2003年8月至2007年8月本院对54例严重胫骨开放性骨折采用分期处理的方法进行治疗,最终采用锁定钢板进行内固定,术后观察其疗效。结果术后随访12～24个月,平均18个月,术后无骨折畸形愈合,无深部感染发生,无小腿筋膜室综合征发生,无严重创口并发症发生,无一例内固定无失效。骨折于4～10个月全部达临床愈合。结论胫骨开放骨折的分期处理,能减少感染及创口并发症。应用有限切开复位锁定钢板内固定治疗严重胫骨开放骨折,具有手术损伤小,操作简便,内固定可靠,对局部血供影响小的优点,有利于骨折愈合,是治疗严重胫骨开放性骨折的有效方法。

Objective To explore the staged management of severe tibia open fractures,and to analyze the effects of the locking compression plate in the treatment of such fractures.Methods Staged management were used for the treatment of 54 cases of severe open fractures of tibia,and the locking compression plate were used for definitive fixation.Results All cases were followed up from 12 months to 24 months,average in 18 months,there were no significant complications such as malunion,infection,soft tissue failure,compartment syndromes,and loss of fixation happened.All the patients got bone union in 4 to 10 months.Conclusion The use of staged management for the treatment of severe tibia open fractures can decrease the complication rates,including wound compromise.The use of locking compression plate for definitive fixation made the operation simple,and with less soft tissue compromise,which was benefit for bone healing.