外固定器治疗胫腓骨骨折的应力适应性

The stress adaptability of the tibial fractures after the external fixation

目的 :探索临床上如何把握骨外固定治疗胫腓骨骨折的应力适应性。方法 :89例胫腓骨骨折病例采用外固定器治疗 ,就功能锻炼强度 ,外固定器应力调整 ,外固定器拆除最佳时机 ,尤其是超声直方图动态监测定量评价骨折愈合程度的辅助作用进行研究。结果 :多数病例 10～ 14w骨折愈合 ,骨不连或延期愈合的病例 6～ 10月愈合 ,1例多段骨折发生再骨折改为带锁髓内钉固定。结论 :术后 1w扶拐下地进行锻炼行走 ,负重 15～ 2 5kg ,术后 6w超声直方图灰阶值达健侧 5 0 %～ 60 % ,结合X线和临床表现综合分析 ,拆除外固定器 ,减少应力遮挡 。

Objective:It explored how to grasp stress adaptability of the tibial and fibula fractures after external fixation in the clinic.Methods:89 cases of the tibial fractures were treated with external fixation.It was study that the strength of patient exercised,external fixators adjusted and removed and the role of ultrasonic histogram detected the fracture healing especially.Results:The most fractures healing was 10～14 weeks.1 caes of refracture(three segmental) changed to treat with interlocking nail.Conclusion:The patients walked weight-bearing with 15～25kg after operation a week.It was not untie six weeks after operation and ultrasonic histogram gray scale of bone regained 50～60% of the contrast and combined with radiographic,clinical manifestations that the external fixation remover,for reducing stress protection and being suitable for fracture healing.