分期手术治疗胫腓骨下段开放骨折  

Staged operation foRopen fracture of loweRtibiofibula

作　　者：倪凌之[1] 赵琦辉[1] 雷文涛[1] NI Ling-zhi;ZHAO Qi-hui;LEI Wen-tao(Dept of Orthopaedics,the Third People′s Hospital of Hangzhou,Hangzhou,Zhejiang 310009,China)

机构地区：[1]杭州市第三人民医院骨科,浙江杭州310009

出　　处：《临床骨科杂志》2022年第2期284-287,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨分期手术治疗胫腓骨下段开放骨折的疗效。方法采用分期手术治疗18例胫腓骨下段开放骨折患者:一期行急诊清创、腓骨内固定及胫骨外固定支架固定,二期行胫骨切开复位内固定术。记录骨痂开始形成时间、骨折愈合情况、并发症发生情况。采用AOFAS踝-后足功能评分标准评定踝关节功能,并记录踝关节活动度。结果患者均获得随访,时间11~30个月。骨痂开始形成时间2~3(2.5±0.3)个月。骨折均愈合,时间4~8(5.5±1.3)个月。未发生深部感染、骨髓炎、内固定松动及断裂等并发症。末次随访时,采用AOFAS踝-后足功能评分标准评定踝关节功能:优8例,良9例,可1例;踝关节活动度:背伸10°~20°,跖屈28°~47°。结论治疗胫腓骨下段开放骨折,一期正确清创和选择合适的腓骨内固定方法,二期行胫骨切开复位内固定术,可取得满意疗效。Objective To investigate the efficacy of staged operation in the treatment of open fractures of loweRtibiofibula.Methods Eighteen patients with open fracture of loweRtibiofibula were treated by staged operation.The first stage was performed with emergency debridement,fibulaRinternal fixation and external fixatoRof tibia,and the second stage was performed with open reduction and internal fixation of tibia.The callus formation time,fracture healing,ankle joint range of motion(ROM)and complications were recorded.AOFAS ankle-hindfoot function score standard was used to evaluate ankle function.Results All patients were followed up foR11~30 months.The callus formation time was 2~3(2.5±0.3)months.All fractures healed within 4~8(5.5±1.3)months.No complications such as deep infection,osteomyelitis,loosening and fracture of the internal fixation occurred.At the last follow-up,the ankle function assessment result of AOFAS ankle-hindfoot function score criterion:excellent in 8 cases,good in 9 cases,and faiRin 1.The ankle joint ROM:the dorsiflexion was 10°~20°,and plantar-flexion was 28°~47°.Conclusions One-stage correct debridement and selection of appropriate fibula internal fixation,with two-stage open reduction and internal fixation of tibia,which can achieve satisfactory results in the treatment of open fractures of loweRtibiofibula.

关 键 词：胫腓骨开放骨折 分期治疗 骨折固定术 

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