二期经小腿后内侧入路植骨治疗胫骨下段开放骨折术后骨缺损

Second stage bone-grafting by posteromedial approach for postoperative bone defect of distal tibia open fracture

目的探讨二期经小腿后内侧入路植骨治疗胫骨下段开放骨折术后骨缺损的临床疗效。方法采用二期小腿后内侧入路取髂骨植骨对24例胫骨下段开放粉碎性骨折术后骨缺损的患者进行手术治疗。结果 24例均获随访,时间12～18个月。伤口均一期愈合,无皮肤坏死、伤口感染、骨外露等严重并发症;植骨融合时间距植骨后12～18(16±2)周。踝关节功能根据Mazur评分系统评定:优20例,良2例,可2例。结论小腿后内侧入路因其具有显露充分、术后软组织并发症少等优点,二期经小腿后内侧入路植骨是治疗胫骨下段开放骨折术后骨缺损有效且可靠的方法 。

Objective To observe the effect of second stage bone-grafting by posteromedial approach for postoperative bone defect of distal tibia open fracture.Methods Twenty-four patients of postoperative bone defect with distal tibia open fractures were treated with second stage bone-grafting by posteromedial approach.Results All cases were followed up for 12~18 months.All wounds got primary healing.There were no severe complication such as necrosis of skin and infection and bone exposure.All fractures obtained bone union.The mean healing time was 12~18（16±2）weeks after bone graft.The Mazur score system of ankle showed 20 patients were excellent,2 good,and 2 fair.Conclusions Posteromedial approach has advantages such as good exposure and few complications of soft-tissue.Second stage bone-grafting by posteromedial approach is an effective and reliable treatment for distal tibia open fracture with bone defect after operation.