外固定架加钢板治疗伴有胫骨骨缺损的开放性胫腓骨骨折

韩立仁，赵北，穆卫东等.外固定架加钢板治疗伴有胫骨骨缺损的开放性胫腓骨骨折[J].中华创伤杂志.2013, 29(3):258-261

胫骨骨折,外固定器，骨缺损

韩立仁，赵北，穆卫东，闫军，陈良，韩士章，杨晓飞

252000,聊城市人民医院骨科 山东大学附属省立医院骨科

2013

258-261

2,万方

目的 探讨外固定架加腓骨钢板治疗伴有胫骨骨缺损的开放性胫腓骨骨折的临床疗效和可行性. 方法 选择2005年9月-2011年3月收治伴有胫骨骨缺损的开放性胫腓骨骨折患者21例(GastiloⅢA型15例,GastiloⅢB型5例,GastiloⅢC型1例),所有患者胫骨骨缺损长度为2～6 cm.Ⅰ期行胫骨外固定架以及腓骨钢板固定,Ⅱ期骨缺损处行髂骨植骨. 结果 随访时间为8 ～ 24个月[14.0±10.5)个月],骨缺损均得以重建,患者肢体的长度与健侧之差均＜2 cm,无一例出现马蹄内翻足. 结论 外固定架加钢板是一种治疗伴有胫骨骨缺损的开放性胫腓骨骨折的有效方法,开放性胫腓骨骨折合并胫骨骨缺损在6 cm以内的患者肢体功能及长度均得以重建. Objective To investigate feasibility and effect of external fixator plus steel plate in treatment of open tibiofibular fractures combined with tibial defect.Methods The study involved 21 patients with open fractures of tibia and fibula (15 patients with type Gastilo ⅢA,five with type Gastilo ⅢB and one with type Gastilo ⅢC) with concurrent tibial defect of 2-6 cm.External fixator plus fibular steel plate was performed at the first stage,followed by iliac bone grafting for bone defect at the second stage.Results All patients showed successful reconstruction of the tibial defects with length difference between affected and healthy extremities less than 2 cm in follow-up for (14.0 ± 10.5) months (range,8-24 months).Meanwhile,no talipes equinovarus existed.Conclusions External fixator plus steel plate is an effective method for treating open tibiofibular fractures combined with tibial defect.The length and function of the extremities of patients with open tibiofibular fractures combined with tibial defect of less than 6 cm can be successfully restored.