中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (22): 4144-4149.doi: 10.3969/j.issn.1673-8225.2010.22.039

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

HoffmannⅡ金属外固定架在胫腓骨开放性粉碎骨折中的应用

夏  睿，孔  荣，方诗元，李守民，禹德万，张光平   

  1. 安徽医科大学附属省立医院骨科，   安徽省合肥市 230001
  • 出版日期:2010-05-28 发布日期:2010-05-28
  • 作者简介:夏 睿☆，男，1973年生，安徽省宣城市人，汉族，2006年苏州大学医学院毕业，博士，主治医师，主要从事关节外科、创伤骨科方面的研究。 ahxiarui@163.com

Application of HoffmannⅡ metal external fixator in treatment of open tibiofibular fracture

Xia Rui, Kong Rong, Fang Shi-yuan, Li Shou-min, Yu De-wan, Zhang Guang-ping   

  1. Department of Orthopedics, Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, Anhui Province, China
  • Online:2010-05-28 Published:2010-05-28
  • About author:Xia Rui☆, Doctor, Attending physician, Department of Orthopedics, Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, Anhui Province, China ahxiarui@163.com

PDF

456

被引次数

15

摘要：

背景：钢板内固定在伴有软组织损伤的粉碎性胫腓骨骨折中的应用受到限制。外固定架适合粉碎开放的胫腓骨骨折，早期的外固定架可治疗高能量损伤所致的复杂骨折，但穿针复杂，耗时长，操作难度较大，或者价格较贵，不宜在国内普及。
目的：探讨应用HoffmannⅡ金属外固定架治疗胫腓骨开放性粉碎性骨折的方法，并观察其近期疗效。
方法：于2008-10/2009-10采用HoffmannⅡ金属外固定支架治疗胫腓骨开放性粉碎性骨折25例。HoffmannⅡ外固定架为Stryker公司产品，其中Apex钛针采用钛合金Ti6AI-4V制作具有良好的生物相容性。上肢固定后次日进行功能锻炼，下肢固定后3周嘱患者扶拐下地患肢部分负重。出院后复查时拍摄X射线片，根据骨痂生长情况，决定拆架时间。
结果与结论：病例随访3~15个月，其中18例骨折一期愈合，骨折愈合时间为8~12个月，外固定支架使用时间平均4.5个月；2例行二期植骨；5例正在随访中。1例发生骨感染，4例发生针道局部感染。结果提示组合式外固定架在治疗复杂粉碎骨折中可以充分发挥出螺钉具有的自攻性以及夹具和连接架万向调节、任意组装的特点，创伤小，操作便捷，固定后功能恢复满意。

关键词: 胫腓骨粉碎骨折, 开放性, HoffmannⅡ外固定架, 骨折愈合, 功能恢复

Abstract:

BACKGROUND: Plate fixation is limited in treating comminuted tibiofibular fracture complicated by soft tissue injury. External fixation is appropriate for open tibiofibular fracture. Early external fixator can treat high energy-induced complicated fracture, but its application is limited due to complex operation, long duration or high cost.
OBJECTIVE: To explore the method and short-term effect of HoffmannⅡ metal external fixator on open tibiofibular fracture.
METHODS: A total of 25 cases of open tibiofibular fracture were treated with HoffmannⅡ metal external fixator from October 2008 to October 2009. HoffmannⅡ metal external fixator was purchased from Stryker, and the Apex titanium needle comprising titanium alloy Ti6AI-4V had good biocompatibility. The functional exercise was performed the day following upper limb fixation, and the patients were asked to walk assisting with stick 3 days following lower limb fixation. X-ray was shot to observe callus growth to confirm fixator extraction time.
RESULTS AND CONCLUSION: All patients were followed up for 3-15 months. Of them, 18 cases had bony union in primary stage. The average time of bone union was 8-12 months, and the average time of using external fixator was 4.5 months. Two cases had delayed bony union using bone graft, and five patients were followed up; one case had bone infection, and four cases with local infection. Results show that external fixator displayed advantages in treating open tibiofibular fracture, such as tapping of screws, free adjustment of fixture and connection frame, less trauma, simple operation and favorable functional recovery.

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