单臂外固定架结合自体骨髓移植治疗胫腓骨远端开放粉碎骨折

Single arm outer fix frame combined with autogenous bone marrow grafting for opened comminuted fracture at distal tibia and fibula

目的 :探讨单臂外固定架结合自体骨髓移植治疗胫腓骨远端开放性粉碎骨折的疗效。方法 :17例胫腓骨远端开放性粉碎骨折急诊行清创单臂外固定架固定。软组织愈合 ,在X线电视透视下将 1枚腰穿针准确穿入骨块间隙中 ,然后抽出自体髂骨红骨髓 30ml即刻注入骨折部位 ,共 3次 ,每周一次。结果 :17例骨折均愈合 ,愈合时间 2 0～ 42周 ,平均 32周。结论 :单臂外固定架固定胫腓骨远端开放性粉碎骨折效果良好 ,经皮自体红骨髓移植可明显促进骨折愈合 ,是治疗此类损伤的有效方法之一。

Objective To investigate the effect of single arm outer fix frame combined with autogenous bone marrow grafting for opened comminuted fracture at distal tibia and fibula.Methods 17 cases of fractures were cleaned and fixed on the single arm fix frame in the emergency treatment.When the soft tissue healed up,a waist needle was inserted into the space of the bone under X-ray,and a total of 30ml of bone marrow was drawn from the anterior or posterior iliac crest and was injected immediately into the site of fractures.The procedure was repeated after one week for 3 times.Result All of 17 cases had unioned in 32 (20-42)weeks.Conclusions Fixed on the single arm outer fix frame opened commiunted fractures at distal of tibia and fibula was immobilized well.Percutaneore autogenous bone marrow grafting can improve the union of the fractures.It is an effective method for the treatment of this kind of fractures.