框式外固定架用于开放性胫骨多节段骨折  

The application of box-external fixation in open multisegment fractures of tibia

作　　者：王昌兴 姜涛 吴建民 沈建国 曹根洪 宋小平 张万忠 马亮 俞宏亮 

机构地区：[1]浙江中医学院附属新华医院原浙江省建工医院骨科,浙江杭州310005

出　　处：《中国骨伤》2005年第8期469-470,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨自制框式外固定架在治疗开放性胫骨多节段骨折方面的临床效果.方法:采用自制框式外固定架对23例开放性胫骨多节段骨折的患者进行手术治疗,其中男18例,女5例;平均年龄36岁;按Gustilo-Anderson分类:Ⅱ型9例,Ⅲa型10例,Ⅲb型2例,Ⅲc型2例.结果:术后随访时间9～17个月,平均11个月.23例中骨折Ⅰ期愈合19例,骨折迟缓愈合3例,截肢1例.术中无重要血管神经损伤发生.术后深部感染2例,其中1例于术后2周因骨与软组织广泛坏死、感染无法控制行Ⅱ期截肢,另1例经局部及全身抗感染治疗,去除死骨后愈合.胫骨平台后倾1例.无严重针孔感染和外固定针松动,无畸形愈合,无肢体明显短缩,无再骨折发生.结论:框式外固定架治疗胫骨多节段骨折具有操作简单、固定坚强、对骨折端的血液循环干扰小、利于早期膝、踝关节活动的优点,还适用于近关节的多节段骨折.Objective： To study clinical effect of self-made box-external fixation in open multisegment fractures of tibia.Methods：Twenty-three cases of open multisegment fracture of tibia（ 18 male,5 female with an average age of 36 years）were treated with self-made box-external fixations. According to Gustilo-Anderson, there were type Ⅱ in 9 cases,type Ⅲa in 10,type Ⅲb in 2,type Ⅲc in 2. Results：The mean follow-up was 9 to 17 months（mean, 11 months）. Of 23 cases, 19 cases were healed and 3 retarded to be healed and 1 was amputated. There were postoerative infection in two cases. One case was amputated two weeks after first operation because of extensive soft tissues necrosis and severe infection;The other was healed by apping anti-infection treatment and cutting off sequestrum. Tibial platform retorversion was found in one case. No complications such as neurovascular injury during operation, pinhole infection, pin loosening and postoperative compartment syndrome were found. There were no bone nonunion and malunion and limb shortness and refracture at the original fracture sit. Conclusion：The application of box-external fixation in treating open multisegment fractures of tibia is an ideal method. This method is characterized by simple proeedur, firm fixation, earlier joint motion of the knee and ankle, no interference with blood circulation of the fracture ends, and reliable fixation of proximal joint multisegment fracture.

关 键 词：胫骨骨折 骨折固定术 内 外固定器 胫骨多节段骨折 外固定架治疗 开放性 框式 全身抗感染治疗 术后随访 

分 类 号：R683.420.5[医药卫生—骨科学] R682.6[医药卫生—外科学]