高原地区外固定器治疗严重胫腓骨骨折的经验

发布时间：2018-11-17 20:20

【摘要】：[目的]胫腓骨骨折的治疗难度在于既能保证骨折断端的稳定又能保护已遭受损害的残存血运,尤其在高海拔缺氧状态下,应用外固定器治疗,能够使患者在尽可能不破坏原有血运的基础上,伤后及早恢复骨性结构,减少并发症,早期相对坚强固定,有骨痂形成时则又达到弹性固定的目的。[方法]遵循Ilizarov穿针固定的基本原则,半槽式外固定器治疗胫骨中下段粉碎性骨折31例,男22例,女9例。骨折类型按AO分型:B型16例,C型15例,对术后疗效及影响的相关因素进行分析。[结果]24例获得随访,平均随访时间20个月(6~30个月),采用Johner-Wrubs评定:优17例,良5例,中2例。肢体功能恢复满意。[结论]高海拔缺氧地区外固定器治疗严重胫腓骨骨折,能够达到早期复位、固定、功能锻炼的目的,可有效提高组织血供,预防感染,减少骨不连等并发症,提高救治成功率,是适应高海拔地区的严重胫腓骨骨折治疗良好的固定方法。
[Abstract]:[objective] the difficulty of treatment of tibia and fibula fracture lies in that it can not only guarantee the stability of the broken end of the fracture, but also protect the residual blood circulation which has been damaged, especially in the condition of hypoxia at high altitude, the external fixator is used to treat the fracture. On the basis of not destroying the original blood supply as much as possible, the patients can recover the bone structure as soon as possible after injury, reduce the complications, fix the callus firmly at the early stage, and achieve elastic fixation when the callus is formed. [methods] according to the basic principle of Ilizarov pin fixation, 31 cases of comminuted fracture of middle and lower tibia were treated with half channel external fixator, 22 males and 9 females. According to AO classification, 16 cases of type B and 15 cases of type C. [results] 24 cases were followed up, the average follow-up time was 20 months (6 ~ 30 months). According to Johner-Wrubs evaluation, 17 cases were excellent, 5 cases were good, and 2 cases were middle. The recovery of limb function was satisfactory. [conclusion] the treatment of severe tibia and fibula fracture with external fixator in high altitude hypoxia area can achieve the purpose of early reduction, fixation and functional exercise. It can effectively improve blood supply of tissues, prevent infection and reduce complications such as nonunion. Improving the success rate of treatment is a good fixation method for severe tibia and fibula fracture at high altitude.
【作者单位】：格尔木市人民医院骨科;同济大学附属东方医院;
【分类号】：R687.3

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