CAJ | 학술논문

目的探讨胫前减张切口在治疗老年胫腓骨远端骨折中的临床疗效,并总结其治疗经验.方法对21例老年胫腓骨远段骨折患者采用胫前减张切口切开复位内固定胫骨远端骨折后,将胫前切口内侧皮缘向内推移与胫前肌腱鞘内侧深筋膜缝合,二期对胫前创面游离植皮,术后早期功能康复训练,并对术后疗效进行随访.结果 21例患者随访时间为8～32个月,平均18.3个月.所有患者切口及植皮愈合良好,未出现并发症.所有患者的骨折均在术后3～6个月内获得临床愈合,平均4.2个月.末次随访时,患肢Johner-Wruhs评分:优14例,良5例,中2例,优良率为90.5％.结论采用胫前减张切口内固定治疗老年胫腓骨远端骨折,手术切口进行减张缝合,减少了术后并发症,骨折复位及固定良好,有利于早期功能康复训练及骨折愈合,是目前治疗老年胫腓骨远端骨折的方法之一.
목적 탐토경전감장절구재치료노년경비골원단골절중적림상료효,병총결기치료경험.방법 대21례노년경비골원단골절환자채용경전감장절구절개복위내고정경골원단골절후,장경전절구내측피연향내추이여경전기건초내측심근막봉합,이기대경전창면유리식피,술후조기공능강복훈련,병대술후료효진행수방.결과 21례환자수방시간위8～32개월,평균18.3개월.소유환자절구급식피유합량호,미출현병발증.소유환자적골절균재술후3～6개월내획득림상유합,평균4.2개월.말차수방시,환지Johner-Wruhs평분:우14례,량5례,중2례,우량솔위90.5％.결론 채용경전감장절구내고정치료노년경비골원단골절,수술절구진행감장봉합,감소료술후병발증,골절복위급고정량호,유리우조기공능강복훈련급골절유합,시목전치료노년경비골원단골절적방법지일.
Objective To evaluate the clinical results of anterior tibial relaxation incision in the treatment of elderly patients with fracture of distal tibia and fibula,and to summarize the experience of treatment.Methods Twenty-one elderly patients with distal tibial and fibular fractures with tibial fractures were treated by anterior tibial relaxation incision and internal fixation.The skin of anterior tibial incision was moved inward and sutured with deep fascia of the anterior tibial muscle tendon sheath.The anterior tibial wound was covered by free skin graft in the later.The affected limb could be early functional rehabilitation exercise.The treatment effects were observed and recorded.Results This group of 21 patients were followed up for 8-32 months(average 18.3 months).All patients underwent incision and skin graft healing well,and no patients with complications occurred.The fractures of all patients had reached clinical healing in 3-6 months (average 4.2 months) after surgery.According to Johner-Wruhs score,the final result was excellent in 14 patients,good in 5 cases and fair in 2 cases,with excellence rate of 90.5 ％.Conclusions Anterior tibial relaxation incision can be used in the treatment of elderly patients with fracture of distal tibia and fibula,since it is good for fracture reduction and fixation and is beneficial for the early rehabilitation training and the fracture healing,while the postoperative complications can be reduced by the relaxation incision.