CAJ | 학술논문

目的：探讨锁定钢板外固定治疗胫骨中下段骨折的临床疗效。方法：自2010年1月至2013年1月，采用锁定钢板外固定治疗18例胫骨中下段骨折患者，其中男11例，女7例；年龄13～80岁，平均53．5岁；病程2 h～3 d。骨折按AO分型：A型4例，B型11例，C型3例。开放骨折6例（Gustilo分型：Ⅰ型2例，Ⅱ型3例，Ⅲ型1例），闭合骨折12例。观察患者的手术时间、术后并发症情况，并采用Johner-Wruhs评价标准对术后疗效进行评价。结果：18例患者获随访，时间6～15个月，平均11个月。2例发生局部皮肤坏死（其中1例骨外露），2例骨折延迟愈合（均为开放性骨折），1例钉道感染，均无螺钉松动及折断发生。按Johner-Wruhs评价标准，优10例，良6例，可2例。结论：锁定钢板外固定是治疗胫骨中下段骨折的有效方法之一，具有手术损伤小、手术时间短、术后并发症少、功能恢复好的优点。
목적：탐토쇄정강판외고정치료경골중하단골절적림상료효。방법：자2010년1월지2013년1월，채용쇄정강판외고정치료18례경골중하단골절환자，기중남11례，녀7례；년령13～80세，평균53．5세；병정2 h～3 d。골절안AO분형：A형4례，B형11례，C형3례。개방골절6례（Gustilo분형：Ⅰ형2례，Ⅱ형3례，Ⅲ형1례），폐합골절12례。관찰환자적수술시간、술후병발증정황，병채용Johner-Wruhs평개표준대술후료효진행평개。결과：18례환자획수방，시간6～15개월，평균11개월。2례발생국부피부배사（기중1례골외로），2례골절연지유합（균위개방성골절），1례정도감염，균무라정송동급절단발생。안Johner-Wruhs평개표준，우10례，량6례，가2례。결론：쇄정강판외고정시치료경골중하단골절적유효방법지일，구유수술손상소、수술시간단、술후병발증소、공능회복호적우점。
Objective:To evaluate the effectiveness of locking plate external fixator in treating middle and distal tibial fractures. Methods:From January 2010 to January 2013,18 patients suffered from middle and distal tibial fractures were treated by locking plate external fixator,including 11 males and 7 females,with an average age of 53.5 (ranged from 13 to 80) years old,the course of disease ranged from 2 h to 3 d. According to AO classification,4 cases were type A,11 cases were type B and 3 were type C. Among them,6 patients were open fracture,including 2 cases with typeⅠ,3 cases with typeⅡand 1 case with typeⅢ,according to Gustilo classification),12 patients were close fracture.Operation time,postoperative complications were observed,and Johner Wruhs scoring were used to evaluate clinical outcomes. Results:All patients were followed up from 6 to 15(meaned 11) months. Two cases occurred skin necrosis (1 case occurred bone exposure),2 cases occurred delayed u-nion(all were open fracture),and 1 case occurred nail infection. No screw loosening or broken occurred. According to Johner Wruhs scoring,10 cases obtained excellent result,6 cases good,and 2 cases fine. Conclusion:Locking plate external fixator for the treatment of middle and distal tibial fractures,which has advantages of lessen damage, shorter operative time,less com-plications and rapid functional recovery ,is one of good choice.