Treatment Report Of 84 Cases Complex Tibial And Fibular Fractures And Literature Review

Objective:To study the optimal conditions of various kinds of treatment plans for complex tibial and fibular fractures.Methods:84 cases(90 limbs)of complex tibial and fibular fractures of from January of 2001 to December of 2005 in/at our hospital were analyzed retrospectively,among them,65 cases(70 limbs)were open fractures,50 cases(52limbs)had multi-segment or comminuted tibial and fibular fractures,15 cases(17 limbs)complicated with soft tissue defect,8 cases complicated with vessel and nerve injury,16 cases(18 limbs)complicated with other place fracture or organ injury.We had adopted different fixation ways to 84 cases complex tibial and fibular fractures according to their bone fracture and soft tissue defect condition.34 cases had taken plate fixation,16 cases had taken bone nail,35 cases had taken external fixation and 3 cases had taken calcaneus skeletal traction.Results:71 cases(76 limbs)had followed up ranged from six months to 2 years and three months,average follow-up visit was one year and two months.The shortest time of union of fracture is 90 days and the longest time union of fracture is 289 days,average time of union of fracture is 146 days.The average time of union of fracture In each group was as follow:plate fixation group is 171 days,bone nail group is 115 days,external fixation group is 136 days.There were two cases had amputated in the first stage and three cases had amputated in the second stage. Eight cases had catched infection.Five cases fracture of disunion had unioned well in the second stage after treatment.14 cases transfer of skin flap or musculocutaneous flap was done for soft tissue defect and got a good result. Conclusions:1,correct debridement is the key of treatment of complex tibial and fibular fractures,and is an important measure of guarantee of wound primary closure too.2,Plate fixation should be used carefully in treatment of complex tibial and fibular fracture.Bone nail had demonstrated more evident superiority in treatment of closed tibial and fibular fractures and multi-segment fractures compared with plate fixation and external fixation groups.3,external fixation treatment is the best method to typeâ…¢open fracture as operative soft tissue insult is less.