Wang Liang, Wang Ren, Gu Wei-Dong, Xiong Ya-Lin, Ji Lin
Department of Orthopaedics, the Seventh People's Hospital of Changzhou, Changzhou 213011, Jiangsu, China.
Zhongguo Gu Shang. 2021 Feb 25;34(2):148-52. doi: 10.12200/j.issn.1003-0034.2021.02.010.
To explore clinical effect of bridge-link combined fixation system(BCFS) in treating open middle and lower tibial fractures by external fixation.
From October 2016 to September 2017, 11 patients with open middle and lower tibial fractures were treated with BCFS by external fixation, including 7 males and 4 females aged from 23 to 65 years old with an average of 44.2 years old;the course of disease ranged from 7 to 10 days. All fractures were open, middle and lower tibiofibular fractures. According to AO classification, 5 patients were type A, 5 patients were type B, and 1 patient was type C. All fractures were classified as typeⅡaccording to Gustilo-Anderson classification. The time of fracture healing, postoperative complications were observed, Johner-Wruhs standard were used to evaluate clinical effect.
All patients were followed up from 7 to 13 months with an average of 10.1 months. Fracture healing time ranged from 4 to 8 months with an average of 6.2 months. The removal time of BCFS ranged from 5 to 11 months with an average of 7.8 months. No screws loosening and BCFS breakage occurred after operation, while 1 patient occurred infection of proximal and distal tibia after operation which was healed by anti-inflammatory treatment and dressing change. According to Johner-Wruhs standard, 8 patients were excellent and 3 patients good at the latest follow-up.
BCFS could be used to treat open middle and lower tibial fractures by external fixation, which had features of small size, flexible use, solid and elastic fixation. It could not effectively reduce tissue injury and promote fracture healing, but also have advantages of less postoperative complications and better recovery of limb function.
探讨桥接组合式内固定系统(BCFS)外固定治疗开放性胫骨干中下段骨折的临床效果。
选取2016年10月至2017年9月采用BCFS外固定治疗的11例开放性胫骨干中下段骨折患者,其中男7例,女4例;年龄23~65岁,平均44.2岁;病程7~10天。均为开放性胫腓骨中下段骨折,按AO分型:A型5例,B型5例,C型1例。按Gustilo-Anderson分型均为Ⅱ型。观察骨折愈合时间、术后并发症情况,采用Johner-Wruhs标准评价临床效果。
所有患者均获随访,随访时间7~13个月,平均10.1个月。骨折愈合时间4~8个月,平均6.2个月。BCFS拆除时间5~11个月,平均7.8个月。术后无螺钉松动及BCFS断裂发生,1例患者术后出现胫骨干近端及远端感染,经抗炎换药后愈合。末次随访按Johner-Wruhs标准:优8例,良3例。
BCFS可用于开放性胫骨干中下段骨折的外固定治疗,具有体积小、使用灵活、固定牢固且具有弹性的特点。既能有效减少组织损伤、促进骨折愈合,又具有术后并发症少、肢体功能恢复较好的优点。