摘要
目的探讨单臂外固定架治疗胫骨远端骨折的疗效。方法根据骨折分型确定外固定针的安放部位，A型骨折在骨折两端置外固定针；远端骨折块过小不能容纳外固定针者以及B和C型骨折在骨折近端和跟骨及距骨安放外固定针。撑开复位，复位困难者部分切开复位，植骨螺钉或克氏针固定，合并腓骨骨折同时行切开复位内固定。结果22例外固定架固定3．5-8个月，平均5个月，骨折均愈合，无严重深部感染、骨髓炎、骨折不愈合等严重并发症。随访10-32个月，平均20个月，拆除外固定架康复6个月以上，按Tornetta胫骨远端骨折治疗标准，优11例，良7例，可3例，差1例。结论单臂外固定架固定联合有限切开内固定是治疗胫骨远端骨折简单有效的微创治疗方法之一。
Objective To explore the surgical result of unilateral half-pin external fixation in the treatment of distal tibial fracture. Methods For type A fracture, two pins were inserted into the proximal fragment of tibia fracture and another two pins into the distal fragment ; for type B and C fracture, distal pins were inserted into the talus and calcaneus. The fracture reduction was performed by distraction of external fixators. A limited open reduction was required in some difficult cases to restore the joint surface, with bone grafting and small fragments fixed with wires or screws. Meanwhile, fracture of fibula was fixed with plate and screws. Results The duration of external fixation was 3.5 - 8 months （ mean, 5 months） in 22 patients. Bone union was achieved in all patients, without serious deep infection, osteomyelitis, or non-union. The patients were followed for 10 - 32 months （ mean, 20 months）. Functional exercise was carried out for more than 6 months after the removal of the external fixator. According to the Tornetta＇s evaluation standard, excellent results were obtained in 11 patients, good in 7 patients, fair in 3, and poor in 1. Conclusions Unilateral half-pin external fixation combined with limited open reduction and internal fixation is a simple and effective minimally invasive method for the treatment of distal tibial fracture.
出处
《中国微创外科杂志》
CSCD
2006年第12期914-916,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
胫骨远端骨折
外固定架
Distal tibial fracture
External fixator
