Objective: To investigate the treatment of comminuted superior tibial fracture in complex injury according to damage control orthopaedic. Methods: From Jan. 2007 to Jun. 2009,11 patients suffered from comminuted superior tibial fracture with complex injury,including 8 males and 3 females with an average age of 35.2 years. The external fixator were used to fix tibial fracture in emergency treatment, after 6 weeks when the condition of patients were improved, fix the external tibia by LISS plate through litter incision,fix interior tibia by reconstructed plate or sustained plate. The effect evaluated by Lysholm standard, marking system on the basis of limp,walking stick, angina, knee unsteady, pain, swell, up and down floor, squat. Results:All the postoperative CR showed that the superior tibial fractures were acquired functional reduction ,the incision got well and no infection occurred. All 11 patients were followed-up for 12 to 18 months with an average of 14.7 months. According to an evaluation standard of Lysholm, the results were excellent in 5 cases, good in 4 cases, fair in 1 case, poor in 1 case. Conclusion:According to damage control orthopaedic, the treatment of comminuted superior tibial fracture by external fixation and LISS plate is a suitable method for the patient with complex injury who undergo comminuted superior tibial fracture.%目的:探讨从损伤控制骨科学观点出发治疗复合伤中复杂的胫骨上段粉碎骨折手术方法.方法:2007年1月至2009年6月,胫骨上段粉碎骨折合并其他复合伤的患者11例,男8例,女3例;年龄25～57岁,平均35.2岁.先使用外固定支架临时固定骨折端,6周后患者病情稳定、生理状况改善后再行外侧小切口LISS钢板插入闭合内固定,内侧重建钢板或支持钢板支撑.术后疗效按Lysholm评分标准进行评价.结果:所有患者术后CR示:胫骨上段骨折均获功能复位,伤口愈合良好,无感染.11例均获得随访,时间12～18个月,平均14.7个月.11例患者Lysholm平均评分为(82.8±11.6)分;疗效结果:优5例,良4例,可1例,差1例.结论:依据损伤控制骨科学,先后使用外固定支架、LISS钢板微创固定胫骨上段粉碎骨折,对于合并复合伤的患者是一种比较合适的治疗方法.
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