U形外固定架结合有限内固定治疗干骺端粉碎性骨折

Using U - shape External Fixator Combined with Limited Internal Fixation for Comminuted Via Articular Surface Long Bone Metaph- ysis Fractures

目的 介绍用U形外固定架治疗长骨干骺端经关节面的粉碎性骨折的疗效。方法 2000年2月～2002年9月对8例患者分别采用切开复位少量螺丝钉内固定及U形骨外固定架固定。结果 全部病例均得到随访,随访时间平均11个月。外固定架术后使用时间平均为3.5个月,骨折愈合时间平均为4.5个月,所有骨折均愈合。无骨不连等发生。终末随访时膝关节活动度平均屈95°,伸180°。踝关节平均背伸10°,跖屈28°。结论 外固定架结合有限内固定治疗经关节面的干骺端粉碎性骨折,可避免伤口并发症和骨不连的发生,即能维持骨折对位恢复关节面的解剖关系,又不妨碍关节活动,是治疗长骨干骺端经关节面粉碎性骨折的较好方法。

Objective To present the results of comminuted via articular surface long bone metaphysis fractures treated with an external fixator combined with limited internal fixation. Methods From February 2000 to September 2002, Eight patients with three lower femur metaphysis fractures, there upper tibia metaphysis fractures, two lower tibia metaphysis fractures were treated with self- designed U- shape external fixators combined with limited fixation. Results All patients were followed up with a mean period of 12 months. The average duration of external fixation was 3.5 months. The average bony healed time is 4.5 months. All of the fractures were healed. No nonunion, delayed healing of bone or other complications was found. When lastly followed up, patients averagely resulted of 95 degrees of flexion and 180 degrees of extension of knee, 10 degrees of extension and 28 degrees of flexion of ankle. Conclusion Using external fixator combined with limited internal fixation is a satisfying technique to treat comminuted via articular surface long bone metaphysis fractures. This technique helps to effectively decrease both healing complications of wound and nonunion of bone. With advantage of restoring anatomical articular surface and firmly stabilizing the fracture, this technique also helps to prevent joint stiffness after fixation.