关节活动器外固定架在胫骨远端骨折中的应用

目的探讨使用关节活动器外固定架治疗胫骨远端骨折的治疗方法及临床疗效。方法回顾性分析200801-201101收治的胫骨远端骨折患者38例临床资料,使用关节活动器外固定架结合有限内固定和植骨治疗胫骨远端骨折,观察患者术后伤口感染、皮肤坏死,骨折愈合时间,踝关节运动功能。结果平均随访8月(3～11月),骨折全部愈合,术后踝关节功能根据Johner-Wruhs关节功能评定标准优19,良12,可5,差2,优良率为81.3%,术后无伤口感染及骨折不愈合。结论正确评估软组织条件,根据损伤分型选择合理手术时机及固定方法,使用关节活动器外固定架结合有限内固定和植骨治疗胫骨远端骨折具有手术创伤小,伤口感染率低,骨骼血供破坏小,关节功能恢复好,骨折愈合快等优点,取得良好效果。

The Application of the ExternaL Fixator with the Joint Mo Vement Device to the Distal Tibial Fracture

Objective to discuss the treatment l:or the distal tibial fracture and the clinical efficacy by using the external fixator with the joint movement device.38 Pilon fracture patients in our hospital from January in 2008 to January in 2011 are observed and analyzed retrospectively.The patients are divided into threetypes based on the AO.Methods:A type with 8 cases,B type with 16 cases,C type with 14 cases.By using the external fixator with the joint movement device,the limited internal fixation and the bone grafting,the patients were treated and observed from several aspects:wound infection,skin necrosis,fracture healing time,and motor function of the ankle joint.Results The average interview lasts for 8 months(3-11 lmonths).The interviews show that all fractures have been healed and the function of the ankle joints is scaled,based on the Johner-Wruhs scale of joint function,as:excellent with l9 cases,good with 12 cases,fine with 5cases,bad with 2cases,and the rate of excellence and good is 81.3%.There is no case with wound infection and unhealed fracture after the operation.Conclusions using the external fixator with the joint movement device,the limited internal fixation and bone grafting to cure fractures after the correct evaluation of the soft tissue conditions and choosing proper operation time and fixing method,proves a lot of advantages such as small operation wound,low rate of wound infection,less damage to the bone blood supply,good healing effect of joint function and quick healing of the fractures.