Nathan S S, Lim H H, See H F
Department of Orthopaedics, Changi General Hospital, Singapore.
Singapore Med J. 2000 Mar;41(3):107-10.
The tibia is a subcutaneous bone. Operative fixation of tibial fractures is a demanding undertaking. Thirty-five patients with 36 tibial fractures were admitted to our institution between May 1995 and April 1996. The patients were predominantly male (male to female ratio of 4) and the average age of the patients was 31.4 years (range 14 to 67 years). Ten fractures were located in the proximal third, 18 in the middle third and 8 in the distal third. The indications for operation included displaced intra-articular fragments, failed conservative treatment, compartment syndrome, multiple fractures and unstable fracture configuration. Operative procedures included plating in 29 cases and nailing in 7 cases. These patients were reviewed retrospectively and assessed for complications and radiological and functional outcome. The overall results were satisfactory in 88.9% and poor in 11.1%. The complications were reviewed and various factors affecting the incidences analysed. Three deep infections occurred. All were found after discharge from inpatient care. A prolonged interval between admission and surgery as well as high energy of impact are thought to be the main contributing factors.
胫骨是一块皮下骨。胫骨骨折的手术固定是一项艰巨的任务。1995年5月至1996年4月期间，有35例患者共36处胫骨骨折被收治入我院。患者以男性为主（男女比例为4），平均年龄为31.4岁（范围为14至67岁）。10处骨折位于近端三分之一处，18处位于中段三分之一处，8处位于远端三分之一处。手术指征包括关节内骨折块移位、保守治疗失败、骨筋膜室综合征、多发骨折以及骨折形态不稳定。手术方式包括钢板内固定29例，髓内钉固定7例。对这些患者进行了回顾性研究，并评估了并发症以及影像学和功能结果。总体结果满意的占88.9%，差的占11.1%。对并发症进行了回顾，并分析了影响发生率的各种因素。发生了3例深部感染。均在出院后发现。入院至手术间隔时间延长以及高能量撞击被认为是主要促成因素。
