[摘要]目的探讨复杂严重胫腓骨远端骨折的治疗方法。方法9例行切开复位内固定,12例行有限内固定+石膏外固定治疗方法。结果 按Johner-wruh评定标准,切开复位内固定组(9例):优4例,良2例,差3例,优良率66.7%。有限内固定与石膏外固定结合组12例,优7例,良4例,差1例,优良率90.9%,无软组织并发症。结论重建胫腓骨远端立体平衡与稳定是治疗复杂严重胫腓骨远端骨折的关键。影响复杂严重胫腓骨骨折疗效的因素,不仅是骨折的整复固定,更重要的是如何避免软组织有关并发症。有限切开内固定+石膏外固定可有效预防局部软组织并发症,是治疗复杂严重胫腓骨远端骨折的较好方法。

    [关键词]复杂严重;胫腓骨远端;有限内固定;立体平衡与稳定

    [中图分类号] R683.42 [文章标识码]A[文章编号]

    Discussion on the treatment of complex-serious distal tibiofibula fractures

    [Abstract] objective To Discuss on the treatment of the complex-serious distal tibiofibula fractures. Methods Nine cases were treated by open reduction and internal fixation, twelve were treated by limited internal fixation combined with external fixation of plaster. ResultsAccording to the criteria of Johner and Wruh, sixty six point seven percent patients in the open reduction group (9cases) had an excellent or good result. Ninety point nine percent patients (12cases)treated by limited internal fixation combined with external fixation of plaster had an excellent or good result. ConclusionIt is a key point to reconstruce the tridimensional balance and stability of the distal tibiofibula in the treatment of complex-serious distal tibiofibula fractures. Beside the reduction of fractrue, avoiding soft tissue complication is also important.limited internal fixation combined with external fixation of plaster may prevent soft tissue complications. It is a good method to treat complex-serious distal tibiofibula fractures. ......