摘要
目的探讨胫前减张切口在治疗老年胫腓骨远端骨折中的临床疗效，并总结其治疗经验。方法对21例老年胫腓骨远段骨折患者采用胫前减张切口切开复位内固定胫骨远端骨折后，将胫前切口内侧皮缘向内推移与胫前肌腱鞘内侧深筋膜缝合，二期对胫前创面游离植皮，术后早期功能康复训练，并对术后疗效进行随访。结果21例患者随访时间为8—32个月，平均18．3个月。所有患者切口及植皮愈合良好，未出现并发症。所有患者的骨折均在术后3～6个月内获得临床愈合，平均4．2个月。末次随访时，患肢Johner—Wruhs评分：优14例，良5例，中2例，优良率为90．5％。结论采用胫前减张切121＇内固定治疗老年胫腓骨远端骨折，手术切口进行减张缝合，减少了术后并发症，骨折复位及固定良好，有利于早期功能康复训练及骨折愈合，是目前治疗老年胫腓骨远端骨折的方法之一。
Objective To evaluate the clinical results of anterior tibial relaxation incision in the treatment of elderly patients with fracture of distal tibia and fibula, and to summarize the experience of treatment. Methods Twenty-one elderly patients with distal tibial and fibular fractures with tibial frac-tures were treated by anterior tibial relaxation incision and internal fixation. The skin of anterior tibial incision was moved inward and sutured with deep fascia of the anterior tibial muscle tendon sheath. The anterior tibial wound was covered by free skin graft in the later. The affected limb could be early functional rehabilitation exercise. The treatment effects were observed and recorded. Results This group of 21 patients were followed up for 8-32 months（ average 18.3 months）. All patients under- went incision and skin graft healing well, and no patients with complications occurred. The fractures of all patients had reached clinical healing in 3-6 months （average 4.2 months） after surgery. According to Johner-Wruhs score,the final result was excellent in 14 patients, good in 5 cases and fair in 2 cases, with excellence rate of 90.5%. Conclusions Anterior tibial relaxation incision can be used in the treatment of elderly patients with fracture of distal tibia and fibula, since it is good for fracture reduction and fixation and is beneficial for the early rehabilitation training and the fracture healing, while the postoperative com-plications can be reduced by the relaxation incision.
出处
《中国实用医刊》
2013年第23期90-92,共3页
Chinese Journal of Practical Medicine
基金
山话省卫生厅科研项目（201202052）
关键词
胫腓骨
骨折
老年
减张切口
Tibia and fibula
Fracture
Elderly
Relaxation incision
