目的 探讨单臂外固定器和组合式外固定器治疗小儿胫骨骨折的适应证及优缺点.方法 回顾性分析1998年2月～2011年2月用单臂外固定器和组合式外固定器治疗78例小儿胫骨骨折临床资料,对骨折愈合时间及钉道感染的原因进行分析.结果 本组病例随访5～18个月、平均7个月,骨折愈合平均时间6.2个月.单臂外固定器组:骨折延迟愈合病例:闭合复位4例,有限内固定0例,开放骨折3例；钉道感染病例:闭合复位9例,有限内固定3例,开放骨折5例.组合式外固定器组:骨折延迟愈合病例:闭合复位2例,有限内固定l例,开放骨折2例；钉道感染病例:闭合复位3例,有限内固定3例,开放骨折4例.结论 骨折断端的稳定对外固定器的保护理念应受到临床重视,能有效提高骨折愈合时间及防止钉道感染.外固定器主要是维持和稳定骨折,不能依靠外固定器来复位骨折,良好的骨折复位是外固定器治疗成功的关键.%Objective To evaluate the indication and results of different treatment of tibia fracture by unilatemal and modular external fixation. Methods From February 1998 to February 2011, 78 patients with tibia fracture were treated by unilatemal or modular external fixation, we analyses the recover time and the reasons of nail road infection . Results The mean duration of follow up was 7 months (range from 5-18 months). The average time of fracture healing was 6.2 months. The fracture delayed union cases in unilatemal external fixation group include: close fixation 4/11 cases, finite fixation 0/ 19 cases, open fracture 3/19 cases. The nail road infection cases in unilatemal external fixation group include; close fixation 9/11 cases, finite fixation 3/19 cases, open fracture 5/19 cases. The fracture delayed union cases in modular external fixation group include; close fixation 2/5 cases, finite fixation 1/10 cases, open fracture 2/14 cases. The nail road infection cases in modular external fixation group include; close fixation 3/5 cases, finite fixation 3/10 cases, open fracture 4/ 14 cases. Conclusions Doctors must pay attention to that the stable of broken ends of fractured bone can give protect of external fixation. This can shorten the recovery time and prevent nail road infection. Doctors can not depend on external fixation to reduce fractures although it can keep and stabilize the fracture bones. Good reduction is the key to the success of external fixation treatment.
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