Ilizarov环形外固定支架结合中药治疗胫骨骨折骨不连

摘要

Objective:To observe the curative effect of Ilizarov fixator combined with traditional Chinese medicine in the treatment of tibial fractures,bone nonunion.Method:From September 2009 to July 2012,12 cases of tibial nonunion were treated by Ilizarov external fixator,including 8 males and 4 females with an average age of 35 years old ranging from 24 to 56 years.7 cases were left side,5 cases were right side.Tibia proximal fractures in 2 cases,Middle fracture in 3 cases and lower fracture in 7 cases.Bone healing,complications and limb function after surgery were observed at fixed time point.Result:All patients were followed up from 8 to 15 months with an average of 12 months,the bone defects of 12 patients achieved bone healing.The average bone healing time was 7 months(5 to 12 months).The results of Johner-Wruhs evaluation was excellent in 7 cases,good in 4,fair in 1,bad in 0,excellent rate was 91.67%.No neurological,vascular injury,no nonunion and fracture had happened.Infection of pin pinhole fixation occurred in 1 case with a small amount of leakage and the infection was controlled after dressing change and antibiotics.Conclusion:Ilizarov external fixator is an effective method for treatment of tibial nonunion.It is successful reconstruction of limb length,simple operation,less soft tissue injury,and is clinical worthy of promotion.%目的：观察Ilizarov外固定支架结合中药治疗胫骨骨折骨不连的疗效。方法：2009年9月-2012年7月，采用Ilizarov外固定支架结合中药治疗胫骨骨折骨不连患者12例，男8例，女4例；年龄24~56岁，平均35岁；左侧7例，右侧5例；胫骨上段骨折2例，中段骨折3例，下段骨折7例。术后随访观察骨折愈合、并发症发生及患肢功能恢复情况。结果：本组12例患者，均获随访，随访时间8~15个月，平均12个月；骨折均愈合，愈合时间5~14个月，平均7个月。环形外固定支架拆除后患者踝、膝关节功能均恢复正常，活动自如。按Johner-Wruhs评分标准，优7例，良4例，中1例，差0例；优良率91.67％。均无神经、血管损伤发生，均无骨不连、再骨折发生。发生固定针针孔感染1例，有少量渗出，经换药并应用抗生素后感染控制。结论：Ilizarov外固定支架治疗胫骨骨折骨不连，创伤小、并发症少、疗效可靠，是治疗胫骨骨折骨不连的有效方法。