半环槽式外固定治疗内固定失败的胫骨骨折  

Half ring sculcus external fixation in managing tibial fracture after failed internal fixation

作　　者：何清义[1] 吴雪晖[1] 马树枝[1] 王序全[1] 许建中[1] 李起鸿[1] 

机构地区：[1]第三军医大学西南医院骨科,全军矫形外科中心,重庆400038

出　　处：《第三军医大学学报》2008年第8期684-686,共3页Journal of Third Military Medical University

摘　　要：目的评估采用半环槽式外固定治疗胫骨骨折内固定失败的疗效。方法对近15年来收治的65例胫骨骨折内固定失败的病例临床资料进行回顾性分析。65例胫骨骨折内固定失败病例，钢板螺钉内固定42例，螺丝钉加钢丝固定11例，髓内钉固定6例，螺丝钉内固定6例。其中32例有软组织缺损，62例有感染。所有病例均取出失效内固定后采用半环槽式外固定治疗。32例软组织缺损和骨外露，10例经腓肠肌皮瓣转位覆盖，6例用腓肠肌内侧头转位加植皮消除创面，16例采用筋膜皮瓣修复。结果65例中49例伤口Ⅰ期愈合（75％），骨折愈合时间为4～8个月（平均5．9个月）。结论半环槽式外固定是治疗胫骨骨折内固定失败的有效方法。Objective To evaluate the therapeutic effect of half ring sculcus external fixation after failed internal fixation of tibial fracture. Methods Sixty-five cases of tibial fractures after failed internal fixation during the past 15 years were analyzed retrospectively. Among them, 42 cases were fixed with plate and screws, 11 with screws and wires, 6 with intramedullary nails, and 6 with screws. Inadequate soft tissue coverage occurred in 32 cases and infection in 62 cases. All internal fixators were removed and re-fixed with half ring sculcus external fixator. For 32 cases with soft tissue defect, 10 were repaired with gastrocnemius musculocutaneous flap, 6 with medial head of gastrocnemius and 16 with fascial flap. Results Forty-nine out of 65 patients healed in the first term （75%）. Fracture healing time was 4 to 8 months （5.9 months in average）. Conclusion The half ring sculcus external fixation is effective in treatment of tibial fracture after failed internal fixation.

关 键 词：半环槽式外固定 胫骨骨折 内固定失败 

分 类 号：R683.42[医药卫生—骨科学] R687.3[医药卫生—外科学]