半环形外固定支架加解剖钢板治疗胫骨远端开放性粉碎性骨折合并腓骨骨折的研究.docVIP

半环形外固定支架加解剖钢板治疗胫骨远端开放性粉碎性骨折合并腓骨骨折的研究 　　【摘要】 目的 探讨半环形外固定支架加解剖钢板治疗胫骨远端开放性粉碎性骨折（DTOCF）合并腓骨骨折的应用价值。方法 38例确诊治疗的DTOCF合并腓骨远端骨折患者， 依据随机分配原则分为解剖组和对照组， 各19例。对照组给予常规胫骨远端骨折单臂外固定支架腓骨远端重建钢板内固定手术治疗， 解剖组给予胫骨远端半环形外固定支架及腓骨解剖钢板治疗， 采用Baird-Jackson踝关节评分（BJAS）评估疗效并随访1年， 统计分析所有患者骨折愈合时间、手术时间、出血量、疗效和并发症。结果 解剖组骨折愈合时间、手术时间、出血量明显低于对照组， 差异有统计学意义（P0.05）；解剖组患者治疗优良率为94.74%， 对照组患者治疗优良率为78.95%， 前者明显高于后者， 差异有统计学意义（P0.05）；解剖组患者并发症发生率为10.53%， 对照组患者并发症发生率为26.32%， 前者明显低于后者， 差异有统计学意义（P0.05）。结论 胫骨远端骨折半环形外固定支架及腓骨远端骨折解剖钢板治疗， 可有效提高DTOCF合并腓骨远端骨折的疗效， 降低并发症发生， 值得临床作进一步推广。 　　【关键词】 解剖钢板；半环形外固定支架；胫骨远端开放性粉碎性骨折； 腓骨远端骨折 　　DOI：10.14163/j.cnki.11-5547/r.2015.17.004 　　Research of half circular external fixation stand and anatomical plate in the treatment of distal tibia open comminuted fracture complicated with distal fibula fracture KUANG Jia-shou. Department of Orthopedics， Guangdong Zhongshan City Tanzhou Hospital， Zhongshan 528467， China 　　【Abstract】 Objective To investigate the application value of half circular external fixation stand and anatomical plate in the treatment of distal tibia open comminuted fracture （DTOCF） complicated with distal fibula fracture. Methods A total of 38 patients of diagnosed DTOCF complicated with distal fibula fracture were randomly divided into anatomy group and control group， with 19 cases in each group. The control group received conventional surgery by one-arm fixation support for distal tibia fracture and reconstruction plate fixation for distal fibula fracture. The anatomy group received half circular external fixation stand for distal tibia fracture and anatomical plate for distal fibula fracture. Baird-Jackson ankle score （BJAS） was applied for evaluation， and follow-up lasted for 1 year. Fracture heal time， operation time， bleeding volume， curative effect and complications were statistically analyzed. Results The anatomy group had much lower fracture heal time， operation time， and bleeding volume than the control group， and their difference had statistical significanc