| 延期锁定钢板加髓腔植骨治疗胫骨远端骨折 |
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Received:July 24, 2009
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| 作者 | Author | 单位 | Unit | E-Mail |
| 付常国 |
FU Chang-guo |
河南省煤炭总医院骨科,河南 郑州 450002 |
Department of Orthopaedics,the Coal General Hospital of Henan Province,Zhengzhou 450002,Henan,China |
378574829@qq.com |
| 宋自昌 |
SONG Zi-chang |
河南省煤炭总医院骨科,河南 郑州 450003 |
Department of Orthopaedics,the Coal General Hospital of Henan Province,Zhengzhou 450003,Henan,China |
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| 贾琨 |
JIA Kun |
河南省煤炭总医院骨科,河南 郑州 450004 |
Department of Orthopaedics,the Coal General Hospital of Henan Province,Zhengzhou 450004,Henan,China |
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| 刘国华 |
LIU Guo-hua |
河南省煤炭总医院骨科,河南 郑州 450005 |
Department of Orthopaedics,the Coal General Hospital of Henan Province,Zhengzhou 450005,Henan,China |
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| 期刊信息：《中国骨伤》2009年22卷，第11期，第809-811页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：探讨延期切开复位锁定钢板(locking compressing plate,LCP)加髓腔植骨治疗胫骨远端粉碎性骨折的临床疗效。
方法： 2006年3月至2008年9月收治胫骨远端粉碎性骨折29例，男19例，女10例；年龄27～58岁，平均42.5岁。受伤至入院时间2～4 h .按AO分类：43-A1 3例，A2 12例，A3 9例，43-C1 5例。其中开放性骨折11例(GustiloⅠ型5例，Ⅱ型6例),闭合性骨折18例。早期进行跟骨牵引(石膏托外固定5例)、维持液体轻度负平衡及电解质平衡、改善微循环治疗。伤后8～12 d伤肢肿胀明显减轻后进行胫骨骨折切开复位锁定钢板内固定加髓腔自体髂骨移植。早期功能锻炼，术后10～12周X线片显示有明显骨痂形成时逐步负重。
结果：术后切口愈合良好，无明显并发症。随访6～14个月，平均12个月，所有病例均获骨性愈合。按照Mazur踝关节评价标准：优25例，良3例，中1例。
结论：胫骨远端粉碎性骨折应用LCP加髓腔植骨治疗可以减少骨膜和髓腔的破坏，缩短骨折愈合时间，显着降低骨折不愈合率。而且内固定可靠，术后并发症少。但是术前必须正确评估软组织损伤程度、合理选择手术时机。 |
| [关键词]:胫骨骨折 骨折固定术,内 骨移植 |
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| Locking compressing plate combined with bone-grafting in medullary cavity for treatment of the distal fractures of tibia at delayed stage |
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Abstract:
Objective: To explore the clinical effects of delayed open reduction and locking compressing plate(LCP) plus bone-grafting in medullary cavity for the distal comminuted fractures of tibia.
Methods: Twenty-nine patients with the distal comminuted fractures of tibia were treated between March 2006 and September 2008,including 19 males and 10 females,ranging in age from 27 to 58 years with an average of 42.5 years. From wounded to hospital,the time was from 2 to 4 hours. According to AO classification,type 43-A1 were in 3 cases,type A2 in 12 cases,type A3 in 9 cases and type 43-C1 in 5 cases. Among them,there were 11 cases with open fracture(type GustiloⅠin 5 cases,type GustiloⅡin 6 cases) and 18 cases with closed fracture. Calcaneal traction was done in earlier stage (plaster external fixation in 5 cases),keeping the nagative liquid banlance and electrolyte banlance and improving the microcirculation. After the swolen limbs relieved markedly in 8 to 12 days,operating was done by open reduction and LCP internal fixation plus bone-grafting with own ilium in medullary cavity. Functional exercise was undergone in earlier stage and the wounded limbs loading weight on 10 to12 weeks after operation when the X-ray revealed the callus formed markedly.
Results: The incision healed well without severe complication. All patients were followed up for from 6 to 14 months with an average of 12 months. All cases obtained bone union. According to the Mazur's evaluation standard,the results were excellent in 25 cases,good in 3 cases,and fair in 1 case.
Conclusion: The above treatment can reduce the damage of periosteum and medullary cavity,shorten the time of bone healing and decrease the rate of bone nounion markedly. The internal fixation was reliable and less complacation after surgery,but it is very important for the right preoperation assessment to soft tissue injuries and the good operation timing choice. |
| KEYWORDS:Tibial fractures Fracture fixation,internal Bone transplantation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 付常国,宋自昌,贾琨,刘国华.延期锁定钢板加髓腔植骨治疗胫骨远端骨折[J].中国骨伤,2009,22(11):809~811 |
| 英文格式: | FU Chang-guo,SONG Zi-chang,JIA Kun,LIU Guo-hua.Locking compressing plate combined with bone-grafting in medullary cavity for treatment of the distal fractures of tibia at delayed stage[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(11):809~811 |
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