锁定钢板外置治疗胫骨骨折的初步病例报告  

External fixation of locking plate for the treatment of tibial fractures

作　　者：陈文瑶[1] 阙祥勇[1] 李意[1] 罗青林[1] 李新志[1] CHEN Wen-yao QUE Xiang-yong LI Yi LUO Qing-lin LI Xin-zhi(Ren He Hospital of Three Gogres University, Yichang 443001, China)

机构地区：[1]三峡大学仁和医院,湖北宜昌443001

出　　处：《创伤外科杂志》2017年第8期587-589,共3页Journal of Traumatic Surgery

摘　　要：目的观察外置锁定钢板固定一期或二期治疗胫骨骨折的疗效。方法回顾性分析三峡大学仁和医院2015年1月-2016年6月应用外置锁定钢板固定治疗的6例胫骨骨折患者,其中男性5例,女性1例;年龄17~55岁,平均34岁。开放性骨折3例,闭合骨折并腘动脉损伤1例,闭合骨折并骨筋膜室综合征2例。观察手术情况、术后创面闭合情况、骨折愈合时间、手术并发症。结果开放性骨折共3例,其中2例急诊全麻下行创面清创,直视下复位骨折断端、克氏针临时固定,1例中段骨折取胫骨锁定钢板,另1例下段骨折取胫骨远端解剖型锁定板。骨筋膜室高压2例,其中近段骨折1例、中段骨折1例,在入院6h内腰麻下行筋膜室双切口开放减压。胫骨近端闭合性骨折合并腘动脉1例,患者同时合并对侧股骨远端闭合骨折、脾破裂、胰腺挫伤,多发肋骨骨折血气胸,急诊行损害控制性手术。所有病例均获随防,平均10个月(6~12个月)。所有病例均获骨性愈合,平均愈合时间6个月(3~11个月),浅表皮肤针道感染2例,伤口处理后愈合。所有病例均未发生医源性神经血管损害、深部感染或移植物断裂等并发症。结论外置锁定钢板固定胫骨骨折可作为部分软组织条件不良的胫骨骨折固定的选择之一。Objective To observe the effect of external locking plate fixation in treating tibia1 fracture. Methods A total of 6 cases of tibial fracture aged 17 to 55 （ average, 34 ） years were treated with external locking plate from Jan. 2015 to Jun. 2016. Five of them were male, and one was female, including open fractures in 3 ca- ses, closed fracture with popliteal artery injury in 1 case, and closed fracture combined with compartment syndrome in 2 cases. The operation situation, postoperative incision closure, complications and fracture healing time were ob- served. Results Of the three open fractures, 2 cases underwent emergency debridement under general anesthesia with reduction of fracture and Kirschner wire fixation. One case of middle fracture was fixed with locking plate and another was fixed with distal anatomical locking plate. Two cases of compartment syndrome with fractures in the dis- tal and proximal part, respectively, were decompressed within 6 h after admission. One case of closed fracture with popliteal artery injury associated with injuries of femur, spleen and pancreas and rib fracture with pneumohemotho- rax was performed damage control surgery. All cases received follow - up with an average of 10 months （ 6 - 12 months ）. All cases got bony healing, with an average healing time of 6 （ 3 - 11 ） months. There was superficial in- fection in 2 cases, who received wound healing after treatment. None of the cases had complications such as iatro- genic neurovascular injury, deep infection or graft rupture. Conclusion External locking plate fixation of tibial fracture can be one of the selections for treating tibial fracture with bad soft tissue condition.

关 键 词：胫骨骨折 锁定钢板 外置 感染 

分 类 号：R683.42[医药卫生—骨科学]