胫腓骨骨折治疗回顾与分析

Retrospective analysis of the treatment of fracture of tibia and fibula

目的对180例新鲜胫腓骨骨折治疗进行回顾及分析,以获取更多的认识和经验。方法本组126例,共180侧。包括保守治疗15例,小腿张力较高,其中1例胫前皮肤坏死,2例骨筋膜室综合征形成;开放性骨折38例,并行外固定支架固定;行钢板内固定11例,并发胫前皮肤坏死4例。结果 126例胫腓骨骨折患者急行切开复位,内固定术,腓侧减压,胫前皮肤用刀片刺小孔减压,未发生胫前皮肤坏死及骨筋膜室综合征。二期行腓侧皮肤缝合。平均住院时间20 d,出院达规定治愈标准,定期复查,对149例患者随访8个月,取出内固定物123例。发生骨折延迟愈合4例,骨不连3例。结论对新鲜胫腓骨骨折,应仔细分析和评估病情,注意并发症的发生,合理选择治疗方案,减轻患者的痛苦和经济负担,达到最佳治疗目的 。

Objective To review and analysis the 180 cases of fresh fracture of tibia and fibula, to obtain more cognition and experience. Methods 126 cases of this group, a total of 180 cases. Including 15 cases of expectant treatment, the higher the tension leg, which one cases of anterior tibial skin necrosis, two cases of osteofascial compartment syndrome; 38 cases of compound fracture, simultaneous treatment with external fixation; 11 cases of internal fixation with beard fixation, complicated tibial four cases of cutaneous necrosis. Results 126 cases of patients with fractures of tibia and fibula are opened reduction, internal fixation, fibular decompression, anterior tibial skin with a blade and proded holes decompression, the skin was no necrosis of the anterior tibial and osteofascial compartment syndrome, skin closure ad secundam vicem. Average length of stay is 20 days, dischg up to criterion of cure, regular review of 149 cases of patients with fallow - up eight month, 123 cases of internal fixation dislodged. Occurred in four cases of late healed of fractures, 3 cases of nonunion. Conclusion Fresh fractures of tibia and fibula should be carefully analyzed and appraisaled pathogeuetic condition, pay attention to the occur- rence of complications, a reasonable choice of treatment perseription to alleviate the suffering of patients and economic burden, to achieve the best goals of treatment. A number of closed and open fractures of tibia and fibula, comminuted fracture of serious injury is more serious and multiplicity pathogenetic condition, treatment is difficult, should carefully analyze and appraisaled pathogenetic condition, select the most optimization treatment plan in patients. To alleviate the suffering and economic burden, to achieve the best goals of treatment. Now treated in our hospital in 2003 -2009 of 180 cases of fracture of tibia and fibula irfformation for everyone reference.