外固定支架治疗胫腓骨下端波及踝关节的严重粉碎性骨折  

External fixation support for the treatment of severe comminuted fractures of distal ends of the tibia and fibula combined with ankle joint injury

作　　者：万智勇[1] 张帆[1] 陈初勇[1] 

机构地区：[1]浙江省人民医院,浙江杭州310014

出　　处：《中国骨伤》2001年第7期394-395,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的　探索一种治疗胫腓骨下端波及踝关节严重粉碎性骨折较为理想的方法。方法　应用改良Bastiani单臂多功能外固定支架治疗胫腓骨下端波及踝关节的严重粉碎性骨折 47例 ,跟骨牵引石膏外固定治疗 2 2例 ,切开复位钢板螺钉内固定治疗 17例 ,并将其术后随访的疗效进行比较。结果　术后随访 6个月～ 3年 ,平均 15个月。根据病人骨折愈合情况 ,踝关节活动度 ,关节面平整度及检查患者快速行走 2 0 0m(10 0m/min) ,再登 5 0级楼梯后踝关节疼痛、肿胀及其他不适的严重程度评价疗效。其优良率为 :应用外固定支架治疗为 74 5 % ,跟骨牵引石膏外固定治疗为 5 7 1% ,切开复位钢板螺钉内固定治疗为 5 6 2 %。结论　应用外固定支架治疗胫腓骨下端波及踝关节的严重粉碎性骨折具有复位理想、固定较牢固、应力遮挡小、手术操作简单、病人可早期下床活动等优点。Objective To explore an ideal method for the treatment of severe comminuted fractures of distal end of tibia and fibula combined with ankle joint injury Methods Of the patients with severe comminuted fractures of the distal ends of the tibia and fibula combined with ankle joint injuries,47 were treated with modified Bastiani’s external fixation support,22 with calcaneal traction combined with plaster cast fixation,17 with plate screw internal fixation after open reduction.The results of the three methods were compared.[HT5”H]Results [HT5”SS]After follow up of 6 months to 3 years with an average of 15 months,the curative effects were evaluated according to fracture union,motion of ankle joint,smoothness of articular surface and seriousness of ankle pain,swelling or other discomfor after walking for 200m(100m/min) and then mounting up for 50 steps.74.5% of the patients treated with external fixation support,57.1% of calcaneal traction combined with plaster cast fixation group and 56.2% of plate screw internal fixation after open reduction obtained excellent and good results.[HT5”H]Conclusion [HT5”SS]This external fixation support has the advantages of ideal reduction,firm fixation,less stress shielding,simple operation and early ambulation etc.,which is especially suitable for the treatment of patients with severe comminuted fracture of the distal ends of the tibia and fibula and ankle joint injuries combined with soft tissue injury or defect of skin.

关 键 词：胫骨骨折 骨折固定术 骨折愈合 踝损伤 治疗 

分 类 号：R683.420.5[医药卫生—骨科学]