单侧外固定架对胫腓骨严重开放性骨折的临床疗效

目的:探讨单侧外固定架对不同部位胫腓骨严重开放性骨折的临床治疗效果及关节恢复功能情况。方法:回顾性分析我院自2013年1月至2015年1月共收治胫腓骨严重开放骨折行单侧外固定术治疗患者,根据骨折部位的不同将所有病例分为三组,A组12例,为胫腓骨近端骨折或波及膝关节,固定时需要跨膝关节固定,B组30例,为胫腓骨中段骨折,固定时不跨关节,C组18例,为胫腓骨远端骨折或波及踝关节,固定时需跨踝关节固定。分别对其进行单侧外固定架手术治疗,术后对所有患者骨折愈合情况及膝、踝关节活动度统计,对比观察各组手术疗效。结果:所有手术均获得成功,无不良事件发生,A组下肢功能优良率为83.3%;B组为96.7%;C组为83.3%。下肢功能恢复情况B组与A、C组相比差异具有统计学意义(P0.05),A组与C组相比差异无统计学意义(P0.05)。A组膝、踝关节功能恢复优良率分别为膝66.7%,踝91.7%;B组为膝93.3%,踝96.7%;C组为膝94.4%,踝72.2%。膝关节功能恢复情况A组与B、C组相比差异具有统计学意义(P0.05),B组与C组相比差异无统计学意义(P0.05)。踝关节功能恢复情况C组与A、B组相比差异具有统计学意义(P0.05),A组与B组相比差异无统计学意义(P0.05)。结论:单侧外固定架对不同部位胫腓骨严重开放性骨折的治疗效果良好,关节恢复情况满意,值得临床推广。

Clinical Efficacy of External Fixation for Severe Open Fractures of the Tibia and Fibula

Objective:To investigate the clinical treatment of unilateral external fixation for severe open fractures of the tibia and fibula in different parts and joint recovery situation.Methods:Retrospective analysis from January 2013 to January 2015, a total tibiofibula treated patients with severe open fracture line of unilateral external fixation treatment, depending on the fracture site all the patients were divided into three groups, Group A of 12 patients, the proximal end of the tibia and fibula fractures or affected knee, the knee fixed needs across fixed, group B 30 cases of fracture of the tibia and fibula in the middle, without cross joint fixation, group C 18 cases of tibia and fibula far end or spread ankle fracture, the need to cross the ankle fixed. All the patients were treated with external fixation, and healing of fracture, the function of ankle and the clinical effects were observed and compared before and after the treatment.Results:All operations were successful, with no adverse events, lower limb function excellent rate in group A was 83.3%; group B was96.7%; group C was 83.3%. Lower extremity functional recovery group B and A, the difference compared with group C was statistically significant (P <0.05), group A and group C had no significant difference (P compared to> 0.05). Group A of knee, ankle excellent function of the knee were 66.7%and 91.7%of ankle; group B was 93.3%in the knee, ankle was 96.7%; group C was 94.4%for the knee, ankle was 72.2%. The differences between group A and group B, group A and group C were statistically significant, while the difference between group B and group C was not statistically significant. Compared with group A and group B, the ankle function recovery in group C showed statistically significant difference (P<0.05); There was no statistically significant difference about the ankle function recovery between group and group B (P>0.05).Conclusion:The unilateral external fixation has better effects on the treatment of tibiofibula at different stages with better joint recovery, which is worthy of clinical promotion.