Ali Ayman M
Department of Orthopedic Surgery, Mansoura University, Mansoura, Egypt.
Eur J Orthop Surg Traumatol. 2013 Apr;23(3):349-55. doi: 10.1007/s00590-012-0989-9. Epub 2012 Apr 10.
This study was conducted to evaluate the outcome of treatment for open fractures of the tibial plateau using external circular fixation combined with or without limited internal fixation. Twenty-five patients (16 males and 9 females) with open fracture tibial plateau were treated with circular external fixator with minimal internal fixation. The mean age of the patients was 36 years (range between 23 and 62 years). According to AO classification system, there was six (24 %) C1, eleven (44 %) C2, and eight (32 %) C3. According to Gustilo and Anderson classification, seven (28 %) were grade 1; nine (36 %), grade 2; six (24 %), grade 3b; and three (12 %), grade 3c. According to ASAMI score, Italy, the results were excellent in 8 (32 %) cases, good in 12 (48 %) cases, and fair in five (20 %) patients. The patients' satisfaction was significantly related to the functional results (p < 0.05). Complications included skin gaping in one case 10 days postoperatively. Pin tract infection was seen in 20 % of cases, one case showed deep infection and no cases of septic arthritis. There is no correlation between the final outcome and articular depression (p > 0.05). Ilizarov external fixator provides acceptable outcomes but with a high rate of complication rate, typical of this type of fracture. It avoids extensive soft tissue dissection.
本研究旨在评估采用环形外固定结合或不结合有限内固定治疗胫骨平台开放性骨折的疗效。25例胫骨平台开放性骨折患者（16例男性，9例女性）接受了环形外固定并辅以最少的内固定治疗。患者的平均年龄为36岁（范围在23至62岁之间）。根据AO分类系统，有6例（24%）为C1型，11例（44%）为C2型，8例（32%）为C3型。根据Gustilo和Anderson分类，7例（28%）为1级；9例（36%）为2级；6例（24%）为3b级；3例（12%）为3c级。根据意大利的ASAMI评分，8例（32%）患者结果为优，12例（48%）为良，5例（20%）为中。患者的满意度与功能结果显著相关（p<0.05）。并发症包括术后10天1例出现皮肤裂开。20%的病例出现针道感染，1例出现深部感染，无脓毒性关节炎病例。最终结果与关节面塌陷之间无相关性（p>0.05）。Ilizarov外固定器提供了可接受的结果，但并发症发生率较高，这是这类骨折的典型情况。它避免了广泛的软组织剥离。
