目的 探讨环形外固定架治疗胫骨近端闭合性粉碎性骨折的临床效果。方法 选择2010-05至2012-05解放军总医院收治的胫骨近端闭合性粉碎性骨折25例,均属于闭合性骨折Tscherne分型中CⅡ型。OTA/AO骨折分型:A3型10例,C2型9例,C3型6例。均采用闭合复位或者有限切开复位骨折块后,应用Orthofix hybrid 外固定架治疗。结果 术后均获得随访,随访时间12～16个月,平均(13.4±3.5)个月。所有患者均获得愈合,时间为4~11个月,平均6个月。术后针道反应4例,经局部换药,口服抗生素后治愈。2例骨折延迟愈合,给予局部自体骨植骨术后愈合。末次随访时影像学RRS评分优良率80%,HSS 膝关节临床功能评分优良率84%。结论 利用环形外固定架治疗胫骨近端闭合性粉碎性骨折临床疗效满意。

Objective To study the clinical efficacy of circular external fixator in treatment of the closed and comminuted proximal tibia fracture. Methods Twenty-five patients with closed and comminuted proximal tibia fracture, including 21 males and 4 females, who were admitted to this department from May 2010 to the corresponding time in 2012 were included in this retrospective analysis. The fracture of all these patients with a mean age at 44 years belonged to CⅡtype according to Tscherne classification while ten of them were classified into A3 type, nine into C2, six into C3 under OTA/AO fracture classification. All the patients were treated with Orthofix hybrid external fixator after closed reduction or limited open reduction. Results All the patients were followed up and the follow-up time was between 12 and 16 months, with an average of(13.4±3.5)months. Patients included in this research all gained bone union, however the time for full healing varied, ranging from 4 to 11 months, with a mean of six months. Four of the cases experienced needle reaction postoperatively, and were all healed by using antibiotics combined with local dressings therapy. Delayed union occurred in 2 cases and healed by bone autograft. The radiographical RRS assessment was performed during the final follow-up, which showed a 80% of the excellent rate. In addition, The excellent rate of HSS score was 84%. Conclusions Circular external fixator contributes to a satisfying outcome in treatment of the closed and comminuted proximal tibia fracture.