外固定支架与AO钢板固定治疗胫腓骨中下段开放性骨折的比较

【作者】 李文；

【导师】 邹季；

【作者基本信息】 湖北中医学院 ， 中医骨伤科学， 2004， 硕士

【摘要】 目的 通过探讨外固定支架与AO钢板内固定治疗胫腓骨中下段开放性骨折的疗效，寻求其合理的固定方式。 方法 收集胫腓骨开放性骨折患者104例，其中外固定支架组(A组)50例，按改良Gustilo-Anerson分类分成3型：Ⅰ型18例，Ⅱ型14例，Ⅲ型18例；AO钢板内定组(B组)54例，Ⅰ型21例，Ⅱ型13例，Ⅲ型20例。分析比较两组各型骨折平均愈合时间，骨折感染率，骨折延迟愈合及骨不连率，并作统计学处理。 结果 随访8-15个月，Ⅰ型胫腓骨开放性骨折平均愈合时间：A组14.5周，B组13.1周；骨折感染率均为0；骨折延迟愈合及骨不连率：A组0，B组4.76％。Ⅱ型胫腓骨开放性骨折平均愈合时间：A组18.7周，B组20.3周；骨折感染率A组为7.14％，B组为7.69％；骨折延迟愈合及骨不连率：A组7.14％，B组7.69％。Ⅲ型胫腓骨开放性骨折平均愈合时间：A组26.6周，B组32.5周；骨折感染率为A组11.11％，B组30％；骨折延迟愈合及骨不连率：A组16.67％，B组35％。 结论 对于Ⅰ型、Ⅱ型胫腓骨开放性骨折的固定，AO钢板内固定不失为一种较好的固定方式，对于Ⅲ型胫腓骨开放性骨折，尤其伴有严重的软组织损伤，感染严重，骨折严重粉碎的首选外固定支架治疗。更多还原

【Abstract】 ObjectTo find an ideal fixation to the open fracture of tibia and fibula through studying the effect with external fixation apparatus and AO plate respectively.Methods104 cases inpatients with open fracture of tibia and fibula were collected .50 cases were treated by external fixation apparatus; 54 cases were treated by AO plate. They were divided into three type, namely Ⅰ,Ⅱ,Ⅲ. Statistic test was used to the average healing time of bone fracture, infectious rate of bone fracture , delayed healing and unhealing rate.ResultsAll the patients were followed up from 8 to 15months. In Ⅰ type fracture , the average healing time of bone fracture of A team was 14. 5 weeks,B team was 13. 1 weeks, infectious rate of bone fracture were all 0, the delayed healing and unhealing rate of A team was 0, B team was 4. 76%; In Ⅱ type fracture , the average healing time of bone fracture of A team was 18. 7 weeks,B team was 20. 3weeks. infectious rate of bone fracture were of A team was 7.14%,B team was 7.69%, the delayed healing and unheal ing rate of A team was 7. 14%, B team was 7. 69%; In Ⅲ type fracture , the average healing time of bone fracture of A team was 26.6 weeks, B team was 32.5 weeks. Infectious rate of bone fracture of A team was 11.1%, B team was 30%. The delayed healing and unhealing rate of A team was 16.67%, B team was 35%;Conclusion　For Ⅰ ,Ⅱ type of open fracture , AO plate is a good fixed way .But external fixation apparatus was a prior choice to Ⅲ type of open fracture of tibia and fibula .especially to those with serious soft issue damage , serious inflammation, serious smashing fracture.更多还原