严重开放性胫腓骨骨折治疗策略浅析  

Strategy Analysis of Clinical Treatment for Grade III Open Tibia and Fibula Fractures

作　　者：张荣凯[1] 杨禄坤[2] 陈琰[3] 赵庆[1] 吴兆亚[1] 

机构地区：[1]中山大学附属第五医院骨科一区,广东珠海519000 [2]中山大学附属第五医院麻醉科,广东珠海519000 [3]厦门大学附属中山医院血液科,福建厦门361000

出　　处：《临床医学工程》2013年第7期825-827,共3页Clinical Medicine & Engineering

摘　　要：目的根据严重胫腓骨开放性骨折的特点,对临床治疗策略进行分析。方法严重开放性胫腓骨骨折(GustiloⅢ型)103例,其中男75例,女28例。通过临床回顾统计分析,对严重胫腓骨开放性骨折治疗策略进行分析总结。结果 103例中,一期结合有限内固定31例;35例需二期手术;因严重感染二期截肢1例;伤口感染10例;术后所有病例均骨愈合,骨愈合时间平均7.3个月,外固定时间平均7.5个月;均未发生骨髓炎。肢体功能按Tornetta评定标准:优81例,良17例,可4例,差1例。结论严重胫腓骨开放性骨折首选外固定架固定,可结合有限内固定,后期采用多种手段进行下肢功能康复的治疗方法,是争取最大限度恢复下肢功能的一种临床治疗策略。Objective To study the strategy of treatment for grade III open tibia and fibula fractures with bone and soft-tissue loss. Methods The retrospective analysis was carried out among 103 cases of type III open tibial fracture, including 75 males and 103 females. Results Among the 103 cases, 31 cases received combining internal external fixation treatment; 35 cases needed following surgeries; 1 case received amputation for severe infection of soft-tissue. All cases got bone union, and the mean time of bone union was 7.3 months. The mean time in external fixation was 7：5 months. None of the cases had a complication of chronic osteomyelitis. Results were evaluated with the Tornetta functional assessment. The bone assessment results were excellent in 81 cases, good in 17 cases, fair in 4 cases and bad in 1 case. Conclusions Combining internal and external fixation, as the first line acute treatment for grade III open tibia and fibula fractures with bone and soft-tissue loss, followed with various therapeutic methods for lower limb function rehabilitation, is a reliable and largely successful treatment strategy for grade III open tibia and fibula fractures.

关 键 词：胫骨 腓骨 外固定器 开放性骨折 Gustilo分型 

分 类 号：R683.42[医药卫生—骨科学]