腓骨钢板内固定治疗开放性胫腓骨骨折

The application of fibular plate internal fixation in management of Gustilo III tibial and fibular fractures

目的 报道腓骨钢板内固定在GustiloⅢ型胫腓骨骨折早期处理中的应用效果。方法 8例均行急诊清创 +腓骨钢板内固定 +胫骨外固定架固定术 ,术后二期行皮瓣移植或植皮手术消灭创面。结果 8例均获随访 ,随访时间 6～ 15个月 ,平均 8 4个月。其中 7例骨性愈合 ,1例骨不连。 2例出现足下垂 ,行踝关节融合术后功能良好。无伤口感染等并发症。结论 在GustiloⅢ型胫腓骨骨折早期处理中 ,行腓骨钢板内固定是一种能保持骨折稳定性 ,防止短缩畸形 ,为下一步骨及软组织重建创造良好条件的好方法。

Objective To investigate primary application of fibular plate internal fixation in the GustiloⅢ tibial and fibular fractures. Methods All 8 cases of Gustilo Ⅲ fractures were performed emergent operation of debridement, fibular plate internal fixation and tibial external fixation. All wounds were covered by flap or skin transplantation in two stage. Results 8 cases were followed up for 6～15 months ( average 8 4 months) . 7 cases got bony union, one case non union. Two cases appeared drop foot and showed excellent function after the ankle joint fusion. No infection and other complications were found. Conclusion In the primary management for Gustilo Ⅲ tibial and fibular fractures, the fibular plate internal fixation is a good method, for it has advantages of rigid fixation to prevent short deformity, so that it could provide good conditions for the later bone or soft tissue reconstruction .