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外固定支架治疗胫腓骨下端波及踝关节的严重粉碎性骨折
Hits: 2140   Download times: 1141   Received:May 31, 2000    
作者Author单位UnitE-Mail
万智勇 WAN Zhi yong 浙江省人民医院,浙江杭州310014 The People's Hospital of Zhejiang Province Zhejiang Hangzhou,310014  
张帆 ZHANG Fan 浙江省人民医院,浙江杭州310014 The People's Hospital of Zhejiang Province Zhejiang Hangzhou,310014  
陈初勇 CHEN Chu yong 浙江省人民医院,浙江杭州310014 The People's Hospital of Zhejiang Province Zhejiang Hangzhou,310014  
期刊信息:《中国骨伤》2001年14卷,第7期,第394-395页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:探索一种治疗胫腓骨下端波及踝关节严重粉碎性骨折较为理想的方法。

方法:应用改良Bastiani单臂多功能外固定支架治疗胫腓骨下端波及踝关节的严重粉碎性骨折47例,跟骨牵引石膏外固定治疗22例,切开复位钢板螺钉内固定治疗17例,并将其术后随访的疗效进行比较。

结果:术后随访6个月~3年,平均15个月。根据病人骨折愈合情况,踝关节活动度,关节面平整度及检查患者快速行走200m(100m/min),再登50级楼梯后踝关节疼痛、肿胀及其他不适的严重程度评价疗效。其优良率为:应用外固定支架治疗为745%,跟骨牵引石膏外固定治疗为571%,切开复位钢板螺钉内固定治疗为562%.

结论:应用外固定支架治疗胫腓骨下端波及踝关节的严重粉碎性骨折具有复位理想、固定较牢固、应力遮挡小、手术操作简单、病人可早期下床活动等优点。尤其适用于伴有严重皮肤软组织损伤及缺损的病人。
[关键词]:胫骨骨折  骨折固定术  骨折愈合  踝损伤
 
External fixation support for the treatment of severe comminuted fractures of distal ends of the tibia and fibula combined with ankle joint injury
Abstract:

Objective:To explore an ideal method for the treatment of severe comminuted fractures of distal end of tibia and fibula combined with ankle joint injury

Methods:Of the patients with severe comminuted fractures of the distal ends of the tibia and fibula combined with ankle joint injuries,47 were treated with modified Bastiani’s external fixation support,22 with calcaneal traction combined with plaster cast fixation,17 with plate screw internal fixation after open reduction.The results of the three methods were compared.

Results: After follow up of 6 months to 3 years with an average of 15 months,the curative effects were evaluated according to fracture union,motion of ankle joint,smoothness of articular surface and seriousness of ankle pain,swelling or other discomfor after walking for 200m(100m/min) and then mounting up for 50 steps.74.5% of the patients treated with external fixation support,57.1% of calcaneal traction combined with plaster cast fixation group and 56.2% of plate screw internal fixation after open reduction obtained excellent and good results.

Conclusion:This external fixation support has the advantages of ideal reduction,firm fixation,less stress shielding,simple operation and early ambulation etc.,which is especially suitable for the treatment of patients with severe comminuted fracture of the distal ends of the tibia and fibula and ankle joint injuries combined with soft tissue injury or defect of skin.
KEYWORDS:Tibial  fractures  Fracture  fixation  healing  Ankle  injury
 
引用本文,请按以下格式著录参考文献:
中文格式:万智勇,张帆,陈初勇.外固定支架治疗胫腓骨下端波及踝关节的严重粉碎性骨折[J].中国骨伤,2001,14(7):394~395
英文格式:WAN Zhi yong,ZHANG Fan,CHEN Chu yong.External fixation support for the treatment of severe comminuted fractures of distal ends of the tibia and fibula combined with ankle joint injury[J].zhongguo gu shang / China J Orthop Trauma ,2001,14(7):394~395
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