中国全科医学2018，Vol.21Issue(2)：239-243,5.DOI:10.3969/j.issn.1007-9572.2017.00.168
显微外科技术结合Ilizarov外固定架治疗胫骨外露合并骨缺损的效果研究
Microsurgical Technique Combined with Ilizarov External Fixator in the Treatment of Open Tibial Fracture with Bone Loss
杨亚东 1周娟 2唐文 1赖光松 1张飞 1刘氜 1魏晓军1
作者信息
- 1. 341000江西省赣州市,赣南医学院第一附属医院骨科
- 2. 341000江西省赣州市,赣南医学院生物化学与分子生物学教研室
- 折叠
摘要
Abstract
Objective To investigate the clinical effect of microsurgical technique combined with Ilizarov external fixator in the treatment of open tibial fracture with bone loss.Methods Fifty cases of open tibial fracture with bone loss treated in the First Affiliated Hospital of Gannan Medical University from July 2011 to April 2016 were selected as the subjects.After complete debridement,the exposed tibial bone was covered by the free skin flap with the microsurgical technique,and bone nonunion was treated by bone transfer with Ilizarov external fixator.Results The duration of surgery ranged from 80 min to 120 min,with an average of(85.0±4.4) min;the length of bone transfer was 5-11 cm,averaged(6.0±4.6) cm;the duration for treatment with Ilizarov external fixator was 13-22 months,averaged(15±3) months;the time required for callus mineralization was 13-23 weeks,averaged(14.0±3.6) weeks;the follow-up period for all patients was 12-28 months,with an average of(16.2±5.5) months.Two cases had distal bone nonunion,but were healed by iliac bone grafting;2 had equinus deformity,and they were treated by correction with external fixator.There were no neurovascular injuries and re-fracture occurred during or after surgery.Based on the assessment by Johner-Wruhs' criteria,the curative effect was excellent in 35 cases,good in 12 cases and poor in 3 cases,with an excellent and good rate of 94％.Conclusion For patients with open tibial fracture and bone loss,using the microsurgical technique with Ilizarov external fixation can achieve good overall clinical efficacy with specific manifestations of reduced amputation rate,promoted fracture healing,and shortened treatment duration.关键词
胫骨骨折/显微外科手术/外固定器Key words
Tibial fractures/Microsurgery/External fixators分类
医药卫生引用本文复制引用
杨亚东,周娟,唐文,赖光松,张飞,刘氜,魏晓军..显微外科技术结合Ilizarov外固定架治疗胫骨外露合并骨缺损的效果研究[J].中国全科医学,2018,21(2):239-243,5.
