【摘要】 目的 探讨高能量损伤致胫骨干骺端粉碎性骨折的微创治疗临床效果。方法 从2001～2004年收治胫骨近干骺端粉碎性骨折8例(包括SchatzcherⅥ型胫骨平台骨折4例)，胫骨远干骺端粉碎性骨折4例(包括Pilon骨折Ruedi Ⅲ型2例)。术中采用小切口有限内固定结合Hybrid外固定支架固定。结果 术后随访6～23个月，平均13个月。12例均全部愈合，平均愈合时间3.3个月。术后膝关节Iowa评分84.5分(73～95分)，主动活动范围平均105°(90°～130°)。踝关节AOFAS评分82.5分(60～90分)。1例出现针道感染，无膝踝关节不稳定。结论 利用闭合复位及有限切开内固定结合外固定支架是治疗胫骨干骺端粉碎性骨折的理想方法。

    【关键词】 胫骨干骺端；Hybrid外固定支架；高能量损伤

    Treatment of high energy injury of tibial metaphyseal with Hybrid external fixation

    HUANG Hai-jing，PANG Gui-gen，WANG Zhi-bin，et al.

    Department of Orthopaedics and Traumatology， Tianjin Hospital， Tianjin 300211，China

    【Abstract】 Objective To evaluate the clinical results of minimally invasive surgical treatment of high-energy tibial metaphyseal comminuted fracture.Methods From 2001 to 2004，8 cases of tibial proximal comminuted diaphyseal-metaphyseal fracture (there were 4 cases of SchatzcherⅥ tibial plateau fracture in the group) and 4 cases of tibial distal comminuted fracture (there were 2 cases of Ruedi Ⅲ Pilon fracture in the group) were treated with limited open reduction internal fixation and Hybrid external fixation.Results All were followed up for an average of 13 months (ranging from 6 to 23). All the fracture got united ......