Limited Internal Fixation Combined with External Fixator for Open Fractures Around the Knee for Earthquake Casualty_West China Medical Journal

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Department of Qrthopaedic, West China Hospital, Sichuan University,Chengdu Sichuan 610041, China;

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Keywords：

膝關節; 骨折; 有限內固定; 外固定

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目的:探討有限內固定結合外固定支架在地震傷員膝關節周圍開放性骨折早期治療中的應用。方法:對汶川大地震中25例膝關節周圍開放性骨折早期采用有限切開復位有限內固定,同時結合外固定支架治療,其中脛骨平臺骨折13例,(SchatzkerⅤ型4例,SchatzkerⅥ型 9例),股骨遠端骨折12例,(AO分型C1型3例,C2型5例,C3型4例),25例開放性骨折按Gustilo分型:GustiloⅡ型5例,GustiloⅢA型8例,GustiloⅢB型10例,GustiloⅢC型2例。結果:術后至患者轉院治療期間兩周內,25例開放性傷口均閉合,8例傷口術后出現表淺感染,經加強局部換藥感染控制,無傷口深部感染。術后復查X線片無關節面塌陷,骨折無成角畸形,患者出院時無外固定支架釘道松動。結論:有限內固定結合外固定支架為不適宜做內固定治療的膝關節周圍嚴重開放性骨折提供了一種有效的治療方法,特別是對于地震等重大災害所造成的復雜傷情不失為一種較理想的方法。

Citation： HU Xudong,WANG Guanglin,PEI Fuxing,et al.. Limited Internal Fixation Combined with External Fixator for Open Fractures Around the Knee for Earthquake Casualty. West China Medical Journal, 2009, 24(7): 1676-1679. doi: Copy

1.	胡裕桐,毛賓堯,王毳.超關節外固定架和有限內固定治療膝關節骨折[J]. 中國矯形外科雜志,2000,12(7):1234-1235.
2.	SB NAIQUE,RT MADHAV,MF PEARSE. The management of highenergy proximal tibial fractures by combined percutaneous internal fixation and circular external fixation.[J].J Bone Joint Surg, 2003, 85B:38-39.
3.	A PAPANIKOLAOU, G.THEODORATOS. Fractures of the tibial bondyles:treatment with external fixation and limited internal fication [J].J Bone Joint Surg, 2004, 86B:159.
4.	吳恒義. 地震傷的特點和救治策略[J]. 創傷外科雜志,2008,10(5):413-415.
5.	袁福祿, 韓廣普,等. 微創內固定系統治療膝關節周圍骨折[J].創傷外科雜志,2008,10(4):366.
6.	王序全,吳雪暉,等. 微創內固定系統在膝關節周圍骨折治療中的初步應用[J].第三軍醫大學學報,2008,4(30):671-674.
7.	ROBERT V, KENNETH J..Minimally Invasive Liss Plating For Fractures Around The Knee[J]. Techniques in Knee Surgery. 2008,7(2):131-136.
8.	ETTER C, CLAES L, KINZL L,RAIBLE M. Treatment by external fication of open fracture Associated with Severe Soft Tissue Damageof the Leg:Biomechanical Principles and Clinical Experience[J].Clin Ortho & Related Research, 1983,9(178):80-88.

1. 胡裕桐,毛賓堯,王毳.超關節外固定架和有限內固定治療膝關節骨折[J]. 中國矯形外科雜志,2000,12(7):1234-1235.
2. SB NAIQUE,RT MADHAV,MF PEARSE. The management of highenergy proximal tibial fractures by combined percutaneous internal fixation and circular external fixation.[J].J Bone Joint Surg, 2003, 85B:38-39.
3. A PAPANIKOLAOU, G.THEODORATOS. Fractures of the tibial bondyles:treatment with external fixation and limited internal fication [J].J Bone Joint Surg, 2004, 86B:159.
4. 吳恒義. 地震傷的特點和救治策略[J]. 創傷外科雜志,2008,10(5):413-415.
5. 袁福祿, 韓廣普,等. 微創內固定系統治療膝關節周圍骨折[J].創傷外科雜志,2008,10(4):366.
6. 王序全,吳雪暉,等. 微創內固定系統在膝關節周圍骨折治療中的初步應用[J].第三軍醫大學學報,2008,4(30):671-674.
7. ROBERT V, KENNETH J..Minimally Invasive Liss Plating For Fractures Around The Knee[J]. Techniques in Knee Surgery. 2008,7(2):131-136.
8. ETTER C, CLAES L, KINZL L,RAIBLE M. Treatment by external fication of open fracture Associated with Severe Soft Tissue Damageof the Leg:Biomechanical Principles and Clinical Experience[J].Clin Ortho & Related Research, 1983,9(178):80-88.

West China Medical Journal

Limited Internal Fixation Combined with External Fixator for Open Fractures Around the Knee for Earthquake Casualty

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