不同时期软组织修复对Ⅲb型胫骨骨折愈合的影响

THE EFFECT OF SOFT TISSUE REPAIRING AT DIFFERENT TIMES ON THE UNION OF TYPE Ⅲb TIBIAL FRACTURE

目的 研究不同时期软组织修复 b型胫骨骨折愈合的影响。方法 1987年 1月～ 1999年 1月治疗 b型胫骨骨折 6 8例 76侧 ,按软组织修复的时间不同分为三组 ,早期 (0～ 7天 ) 31侧 ,中期 (8～ 30天 ) 2 4侧 ,晚期 (>30天 ) 2 1侧。术后比较各组感染、骨不愈合等并发症的发生率和平均骨折愈合时间。结果 早期软组织修复组感染发生率明显低于中、晚期组 ,经统计学处理有非常显著性差异 (P<0 .0 1) ,平均骨折愈合时间短于中、晚期组。结论 创伤 1周内行软组织修复可明显减少 b型胫骨骨折的并发症 ,缩短骨愈合时间。

Objective To investigate the effect of soft tissue repairing at different times on the union of type Ⅲb tibial fracture. Methods From January 1987 to January 1999, seventy-six type Ⅲb tibial fractures were divided into 3 groups: early group(0 to 7 days), subacute group(8 to 30 days), late group(more than 30 days) according to the time of soft tissue repairing. The morbidity rates of complications such as infection, nonunion as well as the time to union were compared respectively. Results Followed up for 10 to 36 months (averaged 24 months), the infection and nonunion rates of early group were lower than that of subacute and late groups( P< 0 01), the average time of fracture union of early group was less than that of subacute and late groups. Conclusion Early soft tissue reparing can decrease the complications and the time to union of Type Ⅲb tibial fracture obviously. The time of “ early ” should be limited in one week and as soon as possible.