摘要
目的回顾性分析胫腓骨严重多段骨折两种治疗方法的疗效，探讨其手术相关问题和比较两种治疗方法优越性。方法应用LISS钢板及解剖接骨钢板治疗胫腓骨严重多段骨折49例，按AO分型：解剖接骨钢板组1A3型8例，2C1型6例，2C2型8例，2C3型9例；LISS钢板组1A3型5例，2C1型4例，2C2型3例，2C3型6例。比较两组在手术时间，术中出血量，切口长度，术后伤口引流量以及骨折愈合时间的差异性。结果LISS钢板组手术时间，术中出血量，切口长度，术后伤口引流量以及骨折愈合时间较解剖接骨钢板组有显著减少。结论LISS钢板是治疗胫腓骨严重粉碎性骨折的理想内固定材料。明确手术适应证，严格掌握操作程序和重视对骨缺损的处理是取得满意疗效的关键。
Objective To evaluate and compare the clinical outcomes of two different treatments for complicated tibia and fibula fracture, less invasive stabilization system （ LISS ） and anatomical plate. Methods From October 2005 to August 2010,49 patients with complicated tibia and fibula fractures were treated with LISS or anatomical plate（ 31 cases in anatomical plate group, and 18 cases in LISS group）. Based on AO classification,there were 8 1A3 cases,6 2C1,8 2C2,and 9 2C3 in anatomical plate group, and 5 1A3 cases,4 2CI ,3 2C2,and 6 2C3 in LISS group. The patients in LISS group were treated with locked plate, and the patients in anatomical plates group were reduced via the incision and treated with an- atomical plates. All patients were followed for 12 to 18 months. Outcomes were compared by analyzing the operative duration, blood loss,incision length, postoperative drainage volume and fracture healing time. Re- suits The patients were followed up for 10 - 36 months postoperatively with an average of 14.5 months. The operative duration, blood loss, incision length, postoperative drainage volume and fracture healing time were significantly improved in the LISS group than those ira the anatomical plate group. Conclusion LISS and anatomical plate can both obtain satisfactory outcomes in our study. Less invasive stabilization system has angel stability. LISS provides an alternative treatment for the complicated distal femoral fractures, and it is new trend. There are fewer traumas, fewer blood losses and more rapid recovery in this approach. LISS is an ideal approach for internal fixation in treatment of severe tibia and fibula comminuted fracture. Proper surgery indications, rigid operation procedures and careful management of bone defect are the keys to optimal curative effect.
出处
《临床外科杂志》
2012年第1期65-66,共2页
Journal of Clinical Surgery
关键词
胫腓骨
骨折治疗
tibia and fibula
fracture
treatment
