同侧腓骨移植结合外固定器治疗胫腓骨粉碎性骨折骨缺损

Combination of transplantation of the ipsilateral fibula and external fixation device for the treatment of comminuted fracture and bone defects of the tibia and fibula

目的 评价同侧腓骨移植外固定支架固定治疗胫腓骨粉碎性骨折骨缺损的疗效。方法 38例均为新鲜骨折。其中 ,开放性骨折 2 9例 ,闭合性骨折 9例 ,均采用同侧腓骨移植 ,长约 8～ 13cm ,两端插入胫骨骨折两端骨髓腔内。单臂外固定支架分别在上、中、下三处 ,在不同平面和方向对骨折和植骨进行固定。同时将骨折粉碎骨块拼排在移植骨周围 ,术后早期活动。结果 38例术后随访 6～ 2 4个月 ,骨痂形成时间 6～ 8周。植骨与主骨愈合时间为 6个月 ,无骨不愈合、骨髓炎感染发现。结论 胫腓骨粉碎性骨折、骨缺损 ,采用同侧腓骨移植 ,既有移植骨功能 ,又可以起到支持和恢复肢体长度作用。骨折愈合快 ,临床疗效满意。

Objective To evaluate the results of the treatment of tibiofibula comminuted fracture and bone defect by the transplantation of the ipsilateral fibula and the external fixaction device.Methods All the 38 cases were fresh fracture,and 29 open and 9 closed fracture.The length of the transplanted ipsilateral fibula was 8～13cm which was inserted into the medullary cavity of fractured tibia,meanwhile,the comminuted fracture bone pieces were placed around the transplanted bone.The patients were encouraged to have early ambulation.Results All 38 cases had post-operative follow-up of 6～24 months.Callus were seen in 6～8 weeks.Union of transplanted bone with the tibia occurred in 6 months.Non-union and infection were not seen.Conclusion Tibiofibula comminuted fracture and bone defect can be treated with transplantation of the ipsilateral fibula.This treatment method is simple and effective.