单边外固定器治疗胫腓骨骨折228例临床分析

Clinical Analysis of Unilateral External Fixation of Tibiofibula Fractures in 228 Cases

目的总结应用单边外固定器治疗胫腓骨骨折临床效果及经验。方法 228例胫腓骨骨折患者,采用局部有限侵入手术,在直视下协助复位,做单边外固定或合并有限内固定。结果本组解剖复位112例(49.1%),功能复位116例(50.9%)。201例获随访,平均时间13(10～16)个月。骨折愈合时间平均11(7～32)周。7～16周227例拆除支架,无肌肉萎缩、骨质疏松、骨不连等并发症发生。术后钉道感染6例,经换药、抗生素治疗后愈合。螺钉松动4例,均更换比原螺钉直径大1.0～1.5 mm的螺钉后痊愈。结论单边外固定器治疗胫腓骨骨折有效避免了伤口感染、骨不连、内固定断裂等并发症,且骨折愈合时间明显缩短,是治疗胫腓骨骨折的较好方法。

Objective To summarize the clinical effects and experiences of unilateral external fixation of tibiofibula fractures.Methods 228 cases of tibiofibula fractures got reduction by a local limited invasive surgery under direct vision,followed by the unilateral external fixation or combined limited internal fixation.Results There were 112 cases（49.1%） of anatomic reduction and 116 cases（50.9%） of functional reduction.201 cases were followed up for an average time of 13（10 to 16） months.Fracture healing time was 11 weeks（7weeks to 8 months）.227 cases removed the unilateral external fixation smoothly without muscle atrophy,osteoporosis or bone nonunion.Postoperative pin tract infection occurred in 6 cases,and screw loosening occurred in 4 cases.Conclusions It can effectively avoid wound infection,bone nonunion or fixator disruption of the unilateral external fixation,and can make the healing time significantly shortened,thus is a better way for tibiofibula fractures.