Hoffmann Ⅱ外固定支架治疗胫骨近远端骨折的初步探讨  

Treatment of tibial proximal and dis tal fractures with HoffmannⅡexternal fixation

作　　者：马勇[1] 徐文华[1] 徐屹[1] 姚浩群[1] 雷刚刚[1] 戴闽[1] 宗世璋[1] 

机构地区：[1]江西医学院第一附属医院骨科,南昌市330006

出　　处：《中华创伤骨科杂志》2004年第12期1427-1428,共2页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨HoffmannⅡ外固定支架在高能量损伤胫骨近远端骨折治疗中的使用及其效果。方法从2003～2004年收治胫骨近远端骨折患者16例,均采用HoffmannⅡ外固定支架治疗。对合并有关节内骨折的病例首先强调关节面的解剖复位,包括韧带复位、经皮撬拨、小切口直视复位,空心螺钉固定或Schanz针的终极固定,然后选择理想的入针点置入外固定架Schanz针,C臂监视下调整力线和对位,安装外固定架。结果经过4～20个月随访,平均13.8个月。16例骨折全部愈合,平均愈合时间3.3个月。其中15例患者膝、踝关节功能正常,1例膝关节伸约5度,屈约30度。2例针道渗出稍多。结论利用间接复位、有限内固定技术结合外固定支架固定是治疗胫骨近远端高能量损伤的一种较理想方法。Objective To explore application and effects o f percutaneous screw fixation and Ho ffmann II external fix-ation in treatment of tibial proxima l and distal fractures caused by high energy injury.Methods From 2003to 2004,16cases of tibial proximal and distal fractu res caused by high energy injury were treated with HoffmannⅡexternal fixation.Anatomic reduction of articular surface was p erformed first for cases complicate d with intraarticular fractures.Ne xt Schanz pins were inserted through the carefully decided point s to fix the external fixator and the a lignment was adjusted under the moni tor of X-ray C-arm.Results All were followed up for an average of13.8months(ranging from 4to 20).All the fractures got united,with a n average healing time of 3.3months.15patients had an excellent function al recovery of knee and ankle joints,but 1patient achieved 5degrees of extension and 30degrees of flexion.2cases experie nced excessive effusion from pin holes.Conclusion HoffmannⅡexternal fixation combined with indirect reduction and limited internal fixation is appropriate for treatm ent of tibial proximal and distal fractures cause d by high energy injury,especially f or those with a poor soft-tissue envelope.[

关 键 词：治疗 胫骨 远端骨折 外固定支架 高能量损伤 患者 外固定架 关节面 

分 类 号：R687.3[医药卫生—骨科学]