Scharf W, Orthner E, Wagner M
Unfallchirurgie. 1984 Aug;10(4):192-9. doi: 10.1007/BF02585727.
27 patients with compound fractures of the lower leg were treated according to the following scheme: Exact excision and surgical cleaning of the wound, reduction of the fragments without further exposure of the bone by additional incision, minimal osteosynthesis, stabilization by means of external fixation device and secondary closure of the accidental wound. During the last year we preferred the V-shaped arrangement in contrast to the tent shaped arrangement of the external fixation device as this minimizes the trauma to the extensor muscles of the foot. After external fixation combined with minimal osteosynthesis (n = 10) the patients had to stay in hospital for 6 weeks only. There was no infection at the incision of neither Steinmann-pins nor Schanz-screws and posttraumatic ostitis only in 1 case was seen. On an average only one secondary operation was necessary, a spongious bonegraft only at 3 patients. On an average the patients had the external fixation device for 5 months, bony union of the fracture was observed after 9 months. In case of external fixation without minimal osteosynthesis (n = 17) the patients had to stay in hospital for 16 weeks, 9 of them had infections at the incision of the Steinmann-pins, 9 of them developed posttraumatic ostitis with fistulae. On an average 4 secondary operations were necessary per patient and 9 patients needed a spongious bonegraft to get bony union of the fracture, which was reached on an average of 17 months.
27例小腿复合骨折患者按以下方案进行治疗：精确切除并手术清理伤口，在不通过额外切口进一步暴露骨质的情况下复位骨折碎片，进行微创接骨术，使用外固定装置固定，然后二期缝合意外伤口。在过去一年中，我们更倾向于采用V形外固定装置排列，而不是帐篷形排列，因为这样可以最大限度地减少对足部伸肌的创伤。在进行外固定并结合微创接骨术（n = 10）后，患者仅需住院6周。斯氏针和斯氏螺钉的切口均未发生感染，仅1例出现创伤后骨炎。平均仅需进行一次二期手术，仅3例患者需要植骨松质骨。患者平均使用外固定装置5个月，骨折在9个月后实现骨愈合。在未进行微创接骨术的外固定病例（n = 17）中，患者需住院16周，其中9例斯氏针切口发生感染，9例出现伴有瘘管的创伤后骨炎。平均每位患者需要进行4次二期手术，9例患者需要植骨松质骨才能实现骨折骨愈合，平均在17个月后达到骨愈合。
