踝套牵引加夹板固定治疗不稳定型胫腓骨骨折效果观察

Clinical Observation on the Curative Effect of Ankle Traction Combined with Splint Fixation in the Treatment of Unstable Tibiofibular Fracture

目的：观察踝套牵引加夹板固定治疗不稳定型胫腓骨骨折的效果。方法：选择笔者所在医院收治的50例胫腓骨骨折患者为研究对象,在两助手沿胫骨长轴做对抗牵引下行手法复位,对位对线基本满意后,根据临床检查,放好前、后、内、外侧夹板及压垫,在踝关节处放置踝套牵引,负重2-5 kg,保持下肢中立位。术后摄床边X线片,复查骨折端对位对线情况,必要时调整夹板、压垫或牵引重量至骨折端理想复位。同时于患者恢复的早、中、晚期配合中药内服、外洗。结果：50例患者中,治疗后达到解剖对位者16例,近解剖对位者27例,功能对位者7例。骨折愈合时间最短为41 d,最长为82 d,平均（53.6±1.3）d,无延迟和骨不连接,无跛行,踝关节及膝关节活动基本正常。结论：踝套牵引加夹板外固定避免了夹板外固定难以纠正胫骨骨折端再移位的问题,也避免了由于手术内固定破坏骨膜导致的部分骨折延缓愈合的发生。

Objective：To observe the curative effect of ankle traction combined with splint fixation in the treatment of unstable tibiofibular fracture. Method：Fifty patients with unstable tibiofibular fracture admitted to our hospital were selected as the objects and were given manual reduction with the help ofpulling the confrontation along the long axis of tibia by two assistants,when satisfied with the counterpoint to the the line,the front,back,inner and outer splint and pad were set based on clinical examination,the anklet traction which weighted 2-5 kg was placed at the ankle joint,maintaining a neutral position of the lower limbs,the postoperative bedside X-ray photos were shot to review the situation of counterpoint to line of fracture ends,the splints,pressure pad or traction weight were adjusted to the ideal reduction if necessary.At the same time,in the early,middle and late phase of recovery period,the patients were given Chinese medicine oral administration and external cleansing.Result：In the 50 patients,16 cases reached the anatomic reduction after treatment,27 patients were close to anatomic reduction,7 cases were functional counterpoint.The healing time was shortest for 41 days,longest for 82 days,averaged at （53.6±1.3）days,without delay,nonunion,or slope type,the activities of patients’ ankle and knee joints were basically normal.Conclusion：Anklet traction combined with splint external fixation can avoid the re-displacement of tibial fracture ends,which was difficult to be corrected by external splint fixation,avoid the delayed healing caused by periosteum damage after internal fixation./