| 外固定支架分期治疗复杂胫骨干骺端骨折 |
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Received:August 20, 2013
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| 作者 | Author | 单位 | Unit | E-Mail |
| 张财义 |
ZHANG Cai-yi |
宣城市人民医院骨科, 安徽 宣城 242000 |
Department of Orthopaedics, the People's Hospital of Xuancheng City, Xuancheng 242000, Anhui, China |
zhangcaiyi@126.com |
| 陶忠亮 |
TAO Zhong-liang |
宣城市人民医院骨科, 安徽 宣城 242000 |
Department of Orthopaedics, the People's Hospital of Xuancheng City, Xuancheng 242000, Anhui, China |
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| 张庆 |
ZHANG Qing |
宣城市人民医院骨科, 安徽 宣城 242000 |
Department of Orthopaedics, the People's Hospital of Xuancheng City, Xuancheng 242000, Anhui, China |
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| 李军 |
LI Jun |
宣城市人民医院骨科, 安徽 宣城 242000 |
Department of Orthopaedics, the People's Hospital of Xuancheng City, Xuancheng 242000, Anhui, China |
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| 汪胜 |
WANG Sheng |
宣城市人民医院骨科, 安徽 宣城 242000 |
Department of Orthopaedics, the People's Hospital of Xuancheng City, Xuancheng 242000, Anhui, China |
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| 王绍刚 |
WANG Shao-gang |
宣城市人民医院骨科, 安徽 宣城 242000 |
Department of Orthopaedics, the People's Hospital of Xuancheng City, Xuancheng 242000, Anhui, China |
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| 唐佶颖 |
TANG Jie-ying |
宣城市人民医院骨科, 安徽 宣城 242000 |
Department of Orthopaedics, the People's Hospital of Xuancheng City, Xuancheng 242000, Anhui, China |
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| 期刊信息：《中国骨伤》2014年27卷，第5期，第425-429页 |
| DOI：10.3969/j.issn.1003-0034.2014.05.018 |
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目的：探讨组合式外固定支架治疗复杂胫骨干骺端骨折的疗效。
方法：自2007年1月至2012年7月采用组合式外固定支架分期治疗34例复杂胫骨干骺端骨折，其中男23例，女11例；年龄16～63岁，平均41.3岁；病程1 h～8 d.31例为开放性骨折，采用Gustilo分型：Ⅱ型11例，ⅢA型13例，ⅢB型7例。胫骨平台骨折19例，采用Schatzker分型：Ⅱ型6例，Ⅳ型1例，Ⅴ型5例，Ⅵ型7例。胫骨远端骨折15例（其中1例患者为双侧），按AO分型：A2型2侧，A3型1侧，C1型1侧，C2型5侧，C3型7侧。分别采用Rasmussen和AOFAS踝-后足评分系统对患者膝、踝关节功能进行评定。
结果：创面获得Ⅰ期愈合19例，Ⅱ期愈合15例。发生浅表伤口感染2例，骨不连2例（再手术后获得骨愈合）.34例患者均获随访，时间6～38个月，平均14.3个月。末次随访时，Rasmussen评分为23.58±3.98，优5例，良11例，可3例；AOFAS踝-后足评分为80.75±14.21，优5例，良8例，可3例。
结论：组合式外固定支架用于治疗复杂胫骨干骺端骨折，能有效维持骨断端的稳定性，组织感染坏死率低，对关节活动影响小，但长期使用有一定局限性。 |
| [关键词]:胫骨 干骺端 骨折 外固定器 |
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| Staging treatment for complex tibial metaphyseal fractures with external fixator |
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Abstract:
Objective: To observe the clinical effects of combined type external fixator in treating complex tibial metaphyseal fractures.
Methods: From January 2007 to July 2012,34 patients with complex tibial metaphyseal fractures were treated with combined type external fixator in different stagings. There were 23 males and 11 females,with a mean age of 41.3 years (ranged,16 to 63),and the course of disease were from 1 h to 8 d. In the patients,31 cases were open fractures,11 cases with typeⅡ,13 cases with type ⅢA,7 cases with type ⅢB according with Gustilo classification;19 cases were tibia plateau fractures,6 cases with typeⅡ,1 case with type Ⅳ,5 cases with type Ⅴ,7 cases with type Ⅵ according to Schatzker classification;15 cases were distal tibial fractures (one were bilateral fractures),2 fractures with type A2,1 fracture with type A3,1 fracture with type C1,5 fractures with type C2,7 fractures with type C3 according to AO classification. Rasmussensn scoring system and AOFAS Ankle Hind-foot Scale were respectively used to assess the joint function of knee and hip.
Results: Wound surface of 19 patients obtained at phaseⅠhealing and 15 patients obtained at phase Ⅱ healing. Superficial wound infections occurred in 2 cases and bone non-union necessitated reoperation occurred in 2 cases (final fractures obtained bone healing after the second operation). All patients were followed up from 6 to 38 months with a mean of 14.3 months. At the final follow-up,according to Rasmussensn scoring system,5 fractures got excellent results,11 good,3 fair,the mean Rasmussen score was 23.58±3.98;according to AOFAS Ankle Hind-foot Scale,5 fractures got excellent results,8 good,3 fair,the mean AOFAS Ankle Hind-foot Scale was 80.75±14.21.
Conclusion: Combined type external fixator can well maintain the stability of the fractures,had advantages of low incidences of soft tissue complications and less influence to joint motion in treatment of complicated tibial metaphyseal fractures,However there were some limitations in long-term use. |
| KEYWORDS:Tibia Metaphysis Fractures External fixators |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张财义,陶忠亮,张庆,李军,汪胜,王绍刚,唐佶颖.外固定支架分期治疗复杂胫骨干骺端骨折[J].中国骨伤,2014,27(5):425~429 |
| 英文格式: | ZHANG Cai-yi,TAO Zhong-liang,ZHANG Qing,LI Jun,WANG Sheng,WANG Shao-gang,TANG Jie-ying.Staging treatment for complex tibial metaphyseal fractures with external fixator[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(5):425~429 |
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