单臂式外固定支架治疗胫腓骨开放性骨折

Treatment of open tibia-fibula fracture with external fixator

目的 :探讨单臂式外固定支架治疗胫腓骨开放性骨折的应用及优越性。方法 :自 1 999年 5月至 2 0 0 3年 7月 ,利用单臂式外固定支架治疗胫腓骨开放性骨折 32例 ,按Gustilo分型 :Ⅰ型 1 1例 ,Ⅱ型 1 3例 ,ⅢA型 3例 ,ⅢB型 4例 ,ⅢC型 1例。结果 :术后病人均给予随访 ,随访时间为 6～ 36个月 ,平均 1 8个月。 3例发生针道感染 ,感染率为 9.37% ,32例均达骨性愈合。骨折愈合时间为 2 .5～ 8月 ,平均 3.9个月。临床疗效满意。结论 :应用单臂式外固定支架治疗胫腓骨开放性骨折 ,手术创伤小 ,操作简单 ,符合外固定原则 ,可早期进行功能锻炼 ,有利于骨折愈合及肢体功能恢复 ,优于其它固定方式。

Objective: To study the application and advantages in the treatment of open tibia-fibular fracture with external fixator. Methods: From May 1999 to July 2003, 32 cases of open tibia-fibula fracture, including 11 type Ⅰ , 13 type Ⅱ , 3 type ⅢA, 4 type ⅢB, 1 type ⅢC, according to Gustilo classification, were reduced and fixed with external fixators. Result: All cases were followed up for 6 to 36 months , averaged of 18 months. 4 cases suffered infection of pin-canals, and the infection rate was 9.37%. All cases had bony union within 2.5～8 months, with the average time of bony union being 3.9 months. The outcome was satisfactory. Conclusion: The advantages of external fixator in treatment of open tibia-fibula fracture are less traumatic, easy to use, devoid of joint stiffness and muscular atrophy, and beneficial to fracture healing and early functional recovery, and it is more effectively than the other ways of fixation.