Hochstein P, Aymar M, Winkler H, Wentzensen A
Berufsgenossenschaftliche Unfallklinik Ludwigshafen.
Unfallchirurgie. 1994 Oct;20(5):259-75. doi: 10.1007/BF02588704.
From 1988 to 1990 a total of 187 fractures of the tibia (92 compound, 95 closed fractures) were treated with a primary osteosynthesis. In 102 fractures an external fixation was performed, 85 internal fixations were divided into 58 intramedullary nails and 27 plates. In a follow-up study the fracture healing was analysed, 90% of the patients were examined about 18 months after the accident. The mean healing time was between 12 weeks (internal fixation) and 16 weeks (external fixateur). After primary Fixateur externe 54 were treated by secondary internal fixation, intramedullary nailing was the method of choice. Contamination rate of the tibia, taken by an intraoperative wound swab before nailing was 30%. Infection occurred in 3.2%, non union and refractures in 1.5% and 1%. Over all 80% excellent and good results were found after consolidation. 10% fair and 10% bad results including three amputations after III degrees compound fractures and three death after polytrauma.
1988年至1990年期间，共有187例胫骨骨折（92例开放性骨折，95例闭合性骨折）接受了一期骨固定治疗。其中102例骨折采用了外固定，85例内固定分为58例髓内钉固定和27例钢板固定。在一项随访研究中，对骨折愈合情况进行了分析，90%的患者在事故发生后约18个月接受了检查。平均愈合时间在12周（内固定）至16周（外固定器）之间。在外固定器治疗后，54例患者接受了二期内固定治疗，髓内钉固定是首选方法。在钉固定前通过术中伤口拭子检测的胫骨污染率为30%。感染发生率为3.2%，骨不连和再骨折发生率分别为1.5%和1%。骨折愈合后总体优良率为80%。10%为尚可，10%为差，包括3例III度开放性骨折后截肢和3例多发伤后死亡。
