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首页> 外文期刊>Archives of orthopaedic and trauma surgery. >Locking plate as a definitive external fixator for treating tibial fractures with compromised soft tissue envelop
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Locking plate as a definitive external fixator for treating tibial fractures with compromised soft tissue envelop

机译：锁定板作为确定的外固定器，用于治疗软组织包膜受损的胫骨骨折

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Introduction: Tibial fractures with compromised soft tissue envelop may lead to significant complications. The optimal management of these injuries remains controversial. Recently, locking plate used as a definitive external fixator is attractive because it not only minimizes trauma to the soft tissues, but also overcomes the shortcomings of standard external fixators. The objective of this study was to evaluate the outcome of using locking plate as a definitive external fixator for treating tibial fractures with compromised soft tissue envelop. Patients and methods: A prospective series of 12 consecutive tibial fractures with compromised soft tissue envelop were treated using locking plate as a definitive external fixator. Of these patients, six were Gustilo and Anderson type IIIA, three were type II and three were closed fractures (AO/ASIF soft tissue injury classification IC4: 2, IC5: 1). Time to union, nonunion, malunion, leg shortening, range of motion and function for the knee and ankle, deep infection, pin tract infections were evaluated. Results: The mean bone healing time was 37.8 weeks (range 20-56 weeks). Eventually, all of the fractures united. Most of the fractures healed in acceptable positions. There were no cases of deep infection. Pin tract infection was seen in 1 (8.3 %) patient, no loosening or failure of the external fixator was seen. At the most recent follow-up, the mean range of motion at the knee was extension 0 to flexion 135, and the mean ankle range of motion was dorsi flexion 12 to plantar flexion 32. All patients had excellent or good functional results and were fully weight bearing with a well-healed tibia at the final follow-up. Conclusion: The locking plate used as a definitive external fixator provided a high rate of union. The patients experienced a comfortable clinical course, excellent knee and ankle joint motion, satisfactory functional results and an acceptable complication rate. However, the stiffness of external locked plating is not clear, therefore, clinical recommendation on its practical use to reduce the risk of implant failure still need to be determined.
机译：简介：胫骨骨折伴软组织包膜受损可能会导致严重的并发症。这些伤害的最佳处理仍存在争议。近来，用作确定性外固定器的锁定板是有吸引力的，因为它不仅使对软组织的损伤最小化，而且克服了标准外固定器的缺点。这项研究的目的是评估使用锁定板作为确定的外固定器治疗软组织受损的胫骨骨折的疗效。患者和方法：使用锁定板作为确定的外固定架，治疗一系列连续的12处胫骨骨折并伴有软组织包络的前瞻性骨折。在这些患者中，古斯塔洛和安德森IIIA型为6例，Ⅱ型为3例，闭合性骨折为3例（AO / ASIF软组织损伤分类，IC4：2，IC5：1）。评估了愈合时间，不愈合，畸形畸形，腿缩短，膝盖和踝关节的运动范围和功能，深部感染，针道感染。结果：平均骨愈合时间为37.8周（范围为20-56周）。最终，所有的骨折融合在一起。大多数骨折均在可接受的位置愈合。没有深层感染的病例。 1例患者（8.3％）出现针道感染，未见外固定架松动或失效。在最近的随访中，膝关节的平均运动范围是0到屈曲135，而踝关节的平均运动范围是背屈12到flex屈32。所有患者均获得了良好或良好的功能结果，并且完全最后一次随访时负重，胫骨愈合良好。结论：用作最终外固定器的锁定板提供了较高的结合率。患者经历了舒适的临床过程，出色的膝盖和踝关节运动，令人满意的功能结果以及可接受的并发症发生率。然而，外部锁定镀层的刚度尚不清楚，因此，仍需要确定有关其实际使用的临床建议，以减少植入失败的风险。

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