双臂外固定架治疗胫腓骨多段开放性骨折的近期疗效

Outcomes of open complex splintered tibiofibular fractures with bilateral external fixation

目的探讨双臂外固定架治疗胫腓骨多段开放性骨折的临床疗效。方法 2003年6月至2010年1月应用双臂外支架固定治疗胫腓骨多段开放性骨折患者52例,男35例,女17例,年龄17～66岁,平均(36±7.3)岁。开放损伤程度按照Gustilo分类:Ⅰ型5例,Ⅱ型20例,Ⅲ型27例。受伤至手术时间2～12 h。结果评定按照Tornetta等评估标准分为优、良、可与差4级。结果全部获得随访,随访时间为6.3个月～3.4年,平均(12±2.3)个月;骨折愈合时间3.3～13.2个月,平均7.3个月。骨折不愈合2例,针孔感染4例9孔,深部感染1例,固定针松动4例,均经治疗后痊愈。关节功能恢复情况根据患者的疼痛程度、关节活动范围和骨折愈合情况等,按照Tornetta等评估标准:优31例,良15例,可4例,差2例,优良率为88.46%。结论双臂外固定支架是治疗胫腓骨多段开放性骨折的一种较好的方法。

Objective To explore the clinical outcomes of open complex splintered tibiofibular fractures with bilateral external fixation.Methods Totally 52 patients with open complex splintered tibiofibular fractures were treated with bilateral external fixation between June 2003 and January 2010.There were 35 males and 17 females with average age of 36±7.3 years（ranged from 17 to 66）.The outcomes were judged by Tornetta criterion post - operatively,and the outcomes were graded into the excellent,the good,the fair and the poor.Results All the patients had been followed up for 6.3 months to 3.4 years（average 12±2.3 months） post - operatively.The bone fractures had healed from 3.3 to 13.2 months with the average of 7.3 months.The infection in wire holes was found in 4 cases（9 holes）,severe infection in 1, wires loose in 4,disunion in 2.But they cured with right measures.The outcomes were the excellent in 31 cases,the good in 15,the fair in 4 and the poor in 2 based on the Tometta criterion post - operatively,and the ratio of the excellent and the good was 88.46%.Conclusion It is a good method to treat open complex splintered tibiofibular fractures using bilateral external fixation.