应用Ilizarov技术治疗Gustilo Ⅲ型胫腓骨开放性粉碎性骨折

The Application of Ilizarov Technique in the Treatment of Gustilo Type Ⅲ Open Comminuted Fracture of Tibia and Fibula

目的：探讨应用Ilizarov技术治疗GustiloⅢ型胫腓骨开放性骨折的疗效。方法回顾性分析2012年5月～2015年12月应用Ilizarov技术治疗的13例GustiloⅢ型胫腓骨开放性骨折患者临床资料，评价治疗效果。结果13例病例早期彻底清创后应用Ilizarov技术复位固定骨折，5例通过二期手术缝合或游离植皮、转移皮瓣修复创面。6例因骨外露及感染清除后骨缺损，予以胫骨截骨行骨搬移术（包括2例双向截骨滑移），2例因血管损伤一期予肢体短缩，二期行胫腓骨截骨、肢体延长术，骨折愈合率100%。踝关节功能优良率84.6%（11/13）。膝关节功能优良率92.3%（12/13）。结论应用Ilizarov技术分期治疗GustiloⅢ型胫腓骨严重开放性骨折安全可靠，具有较好的临床效果。

Objective To investigate the therapeutic effect of Ilizarov technique in open fractures of tibia and ifbula and its complications with GustiloⅢ type. MethodsClinial date of 13 severe open fracture of tibia＆amp;nbsp;and ifbula with type GustiloⅢ from May 2012 to December 2015 were analyzied with retrospective ways, and therapeutic effect was evaluated ResultsAll of 13 cases patients received fracture reduction and fixation with Ilizarov technology in early stage after thorough debridement, and 5 cases patients were repaired wound with free skin graft and transfer lfap, and 6 cases patients were taken osteotomy and bone transport because bone exposure and bone defect, and 2 cases patients were taken limb shortening in 1 stage and limb lengthening in 2 stage, and fracture healing rate was 100%, excellent rate of ankle joint was 84.6%（11/13）, excellent rate of ankle joint was 92.3%（12/13）.ConclusionStage treatment on GustiloⅢtype fracture with Ilizarov technique is safety and reliably, and has good therapeutic effect.