开放性胫腓骨骨折合并胫骨骨缺损的手术治疗  

Surgical treatment of open tibia and fibula fractures associated with tibial bone defects

作　　者：韩立仁[1] 赵北[1] 贺新兵[1] 闫军[1] 韩士章[1] 杨晓飞[1] 

机构地区：[1]山东省聊城市人民医院骨科,252000

出　　处：《中国骨与关节损伤杂志》2014年第4期356-358,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨开放性胫腓骨骨折伴有大段骨缺损的手术治疗方法。方法自2003-09—2012-04对51例开放性胫腓骨骨折伴骨缺损者根据骨缺损长度进行分组,其中24例一期行外固定架结合腓骨钢板固定骨折端,二期骨缺损处行髂骨植骨;27例一期行Ilizarov骨搬移技术治疗胫骨大段骨缺损。结果骨缺损均得以重建,患者肢体长度完全恢复,患者肢体长度与健侧之差均<2 cm,无一例出现畸形,皮肤软组织得到修复。结论外固定架结合钢板固定是治疗合并胫骨骨缺损的开放性胫腓骨骨折的有效方法,骨缺损6 cm以内患者肢体功能及长度得以重建。Ilizarov骨搬移技术也是治疗胫骨大段骨缺损合并软组织缺损的有效方法,尤其适用于骨缺损长度大于6 cm的患者。Objective To explore the methods in the treatment of open tibia and fibula fractures associated with tibial bone defects. Methods A total of 51 cases of open fractures of tibia and fibula from September 2003 to April 2012 were divided into two groups. Twenty four cases of open fractures of tibia and fibula associated with concurrent defect of tibial bone were treated by external fixator and fibula plate at the first stage treatment, and then bone defects were reconstructed with ihac bone grafting at the second stage treatment. Twenty seven patients with acute tibial and soft tissue defects due to compound open tibial fraetures were fixed with Ilizarov System. Results All the 51 cases were followed-up and bone defects were reconstructed with satisfactory limb length of the affected extremities. Discrepaney of the length with the limb contralateral difference was less than 2 era, none of deformity and skin and soft tissue were repaired. Conclusion External fixator and plate is an effective method for treating tibial bone defects less than 6 em with open tibia and fibula fraetures. Ilizarov technique is also an effective option for treating aeute tibial bone defects and soft tissue loss, especially in the bone defect more than 6 cm.

关 键 词：胫腓骨骨折 骨缺损 骨移植 骨搬移 外固定架 ILIZAROV技术 

分 类 号：R687.3[医药卫生—骨科学]