骨外固定加压治疗胫骨骨折内固定失败的疗效观察
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作者Author单位AddressE-Mail
马树枝 MA Shu-zhi 第三军医大学附属西南医院骨科 重庆400038 Department of Orthopaedics,the Affiliated Southwest Hospital of the Third Military Medical University,Chongqing,400038,China spine@tmmu.edu.cn 
王序全 WANG Xu-quan 第三军医大学附属西南医院骨科 重庆400038 Department of Orthopaedics,the Affiliated Southwest Hospital of the Third Military Medical University,Chongqing,400038,China  
许建中 XU Jian-zhong 第三军医大学附属西南医院骨科 重庆400038 Department of Orthopaedics,the Affiliated Southwest Hospital of the Third Military Medical University,Chongqing,400038,China  
李起鸿 LI Qi-hong 第三军医大学附属西南医院骨科 重庆400038 Department of Orthopaedics,the Affiliated Southwest Hospital of the Third Military Medical University,Chongqing,400038,China  
何清义 HE Qing-yi 第三军医大学附属西南医院骨科 重庆400038 Department of Orthopaedics,the Affiliated Southwest Hospital of the Third Military Medical University,Chongqing,400038,China  
期刊信息:《中国骨伤》2005年,第18卷,第3期,第132-134页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:评估胫骨骨折内固定失败后骨外固定的疗效。

方法:43例胫骨骨折内固定失败后采用骨外固定治疗。骨外交叉穿针时,伤口感染应先彻底清创,取出已松动内固定物。稳定性骨折可直接加压固定,不稳定性骨折可借助外固定器连接螺杆牵伸使骨周组织产生一定张力能维持骨折对位、对线,同时也将骨折达到稳定固定。小腿上段软组织缺损选用腓肠肌皮瓣或腓肠肌内侧头转位,中下段用邻近筋膜皮瓣覆盖。

结果:43例中32例伤口Ⅰ期愈合(79%),骨折愈合时间为4~6个月(平均55个月)。

结论:骨外穿针骨折固定牢固,方法简便,对骨端血供干扰小,能早期功能锻炼,有利于骨愈合。同时,也便于术后对伤口观察和处理。
【关键词】股骨骨折  骨折固定术,内  骨科手术方法
 
Observation on the effectiveness of treatment with external compressive fixation after failed tibial internal fixation
ABSTRACT  

Objective:To evaluate the therapeutic effect of treatment with external compressive fixation after failed tibial internal fixation.

Methods:Forty-three patients of failed internal fixation of tibial fracture were transferred to external fixation.Debride the infective wound and removed the loose internal fixator before bone cross-pining immobilization.Direct compression was applied in stable tibial fracture.While in unstable fracture,reduction and alignment were achieved through soft tissue tension produced by extraction of external fixator.The soft tissue defects of proximal leg was repaired with gastrocnemius musculocutaneous flap or transferring medial head of gastrocnemius.The defects in the middle and distal parts were covered with neighboring fascial flap.

Results:Out of the forty-three patients,thirty-two were healed in the first term(79%).Bone healing time was 4 to 6 months(5.5 months in average).

Conclusion:The external fixation is simple and effective,which provids stable fixation,least disturbance of blood supply and facilitated fracture healing,monitoring and treating the wounds dealing postoperation.
KEY WORDS  Tibial fractures  Fracture fixation,internal  Orthopaedics operative methods  
 
引用本文,请按以下格式著录参考文献:
中文格式:马树枝,王序全,许建中,李起鸿,何清义.骨外固定加压治疗胫骨骨折内固定失败的疗效观察[J].中国骨伤,2005,18(3):132~134
英文格式:MA Shu-zhi,WANG Xu-quan,XU Jian-zhong,LI Qi-hong,HE Qing-yi.Observation on the effectiveness of treatment with external compressive fixation after failed tibial internal fixation[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(3):132~134
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