Ⅰ期三维外固定架系统固定联合Ⅱ期内固定治疗GustiloⅢ型胫腓骨开放性骨折的疗效及对功能恢复的影响  

Efficacy of Stage Ⅰ Three-dDimensional External Fixator System Combined with Stage Ⅱ Internal Fixation in the Treatment of Gustilo Type Ⅲ Open Tibiofibular Fractures and the Influence on Functional Recovery

作　　者：杨海东 陈奇鸣[1] YANG Haidong;CHEN Qiming(Huizhou Central People's Hospital,Guangdong Huizhou 516000,China)

机构地区：[1]广东省惠州市中心人民医院手足外科,广东惠州516000

出　　处：《河北医学》2022年第12期2058-2063,共6页Hebei Medicine

基　　金：广东省惠州市科技计划项目,(编号:2018Y241)。

摘　　要：目的:探究Ⅰ期三维外固定架系统固定联合Ⅱ期内固定对GustiloⅢ型胫腓骨开放性骨折疗效及下肢功能恢复的影响。方法:选择2017年4月至2021年4月期间在我院接受手术治疗的93例GustiloⅢ型胫腓骨开放性骨折患者,应用随机数字表法简单随机分为常规组45例,联合组48例,比较两组手术相关指标、临床疗效、下肢功能恢复及术后并发症。结果:联合组手术总时间、术后住院时间、骨折愈合时间均少于常规组(P<0.05),临床疗效等级比较优于常规组(P<0.05)。术前两组GustiloⅢ型胫腓骨骨折患者美国足踝外科协会评分(AOFAS)和美国特种外科医院膝关节评分(HSS)差异无统计学意义(P>0.05);术后6个月两组患者AOFAS评分、HSS评分均升高,联合组手术前后差值高于常规组(P<0.05)。联合组术后总并发症发生率高于常规组(P<0.05)。结论:Ⅰ期三维外固定架系统固定联合Ⅱ期内固定治疗GustiloⅢ型胫腓骨开放性骨折可以减少时间成本,提升临床疗效,患者下肢功能均恢复良好,具有较少的术后并发症。Objective: To investigate the efficacy of stage Ⅰ three-dimensional external fixator system combined with stage Ⅱ internal fixation in the treatment of Gustilo type Ⅲ open tibiofibular fractures, and the influence on lower limb function recovery. Methods: From April 2017 to April 2021, 93 patients with Gustilo type Ⅲ open tibiofibular fractures underwent surgical treatment in the hospital. The patients were randomly divided into conventional group(45 cases) and combined group(48 cases) using the method of random number table. The operation-related indicators, clinical effect, lower limb function recovery and postoperative complications were compared between the two groups. Results: The total operation time, postoperative hospital stay and fracture healing time of the combined group were shorter than those of the conventional group(P<0.05), and the clinical effect was better than that of the conventional group(P<0.05). The American Orthopedics Foot and Ankle Society(AOFAS) score and American Hospital for Special Surgery Knee Score(HSS) showed no statistically significant difference between the two groups before operation(P>0.05). At 6 months after operation, the AOFAS scores and HSS scores were increased in the two groups, and the combined group had higher score difference than the conventional group(P<0.05). The incidence of total complications in the combined group was lower than that in the conventional group(P<0.05). Conclusion: Stage Ⅰ three-dimensional external fixator system combined with stage Ⅱ internal fixation for treating Gustilo type Ⅲ open tibiofibular fractures can reduce time cost, improve clinical effect, and better restore the patients’ lower limb function, with fewer postoperative complications.

关 键 词：胫腓骨开放性骨折 GustiloⅢ型 三维外固定架 

分 类 号：R687.3[医药卫生—骨科学]