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：

膝关节; 骨折; 有限内固定; 外固定

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目的:探讨有限内固定结合外固定支架在地震伤员膝关节周围开放性骨折早期治疗中的应用。方法:对汶川大地震中25例膝关节周围开放性骨折早期采用有限切开复位有限内固定,同时结合外固定支架治疗,其中胫骨平台骨折13例,(SchatzkerⅤ型4例,SchatzkerⅥ型 9例),股骨远端骨折12例,(AO分型C1型3例,C2型5例,C3型4例),25例开放性骨折按Gustilo分型:GustiloⅡ型5例,GustiloⅢA型8例,GustiloⅢB型10例,GustiloⅢC型2例。结果:术后至患者转院治疗期间两周内,25例开放性伤口均闭合,8例伤口术后出现表浅感染,经加强局部换药感染控制,无伤口深部感染。术后复查X线片无关节面塌陷,骨折无成角畸形,患者出院时无外固定支架钉道松动。结论:有限内固定结合外固定支架为不适宜做内固定治疗的膝关节周围严重开放性骨折提供了一种有效的治疗方法,特别是对于地震等重大灾害所造成的复杂伤情不失为一种较理想的方法。

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,毛宾尧,王毳.超关节外固定架和有限内固定治疗膝关节骨折[J]. 中国矫形外科杂志,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.	吴恒义. 地震伤的特点和救治策略[J]. 创伤外科杂志,2008,10(5):413-415.
5.	袁福禄, 韩广普,等. 微创内固定系统治疗膝关节周围骨折[J].创伤外科杂志,2008,10(4):366.
6.	王序全,吴雪晖,等. 微创内固定系统在膝关节周围骨折治疗中的初步应用[J].第三军医大学学报,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,毛宾尧,王毳.超关节外固定架和有限内固定治疗膝关节骨折[J]. 中国矫形外科杂志,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. 吴恒义. 地震伤的特点和救治策略[J]. 创伤外科杂志,2008,10(5):413-415.
5. 袁福禄, 韩广普,等. 微创内固定系统治疗膝关节周围骨折[J].创伤外科杂志,2008,10(4):366.
6. 王序全,吴雪晖,等. 微创内固定系统在膝关节周围骨折治疗中的初步应用[J].第三军医大学学报,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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