目的:探讨提高胫骨GustioⅡ、Ⅲ型开放性骨折疗效的方法.方法:1998年1月～2003年1月共收治胫骨骨折病人106例,36例胫骨GustiloⅡ、Ⅲ型开放性骨折用带锁髓内钉内固定加局部抗菌素灌注治疗,其中15例行局部转移皮瓣修复骨与软组织缺损,全部病例一期植骨.结果:全部开放伤口大部分一期愈合、仅2例ⅢB型骨折术后伤口浅表边缘坏死,经换药治疗三周内愈合,1例ⅢC型骨折行胫前动脉吻合、带锁髓内钉内固定并双蒂桥式皮瓣移植后未能全部覆盖创面,2期改行交腿皮瓣移植再植骨置管灌注后痊愈.随访1个月～5年,其中失访2例,余34例中3例患者术后仅1～2个月,拍片复查已见骨痂生长,余31例骨折全部愈合;无骨感染,关节功能优31例,良2例,中1例.结论:该疗法能同时兼顾控制感染,骨折固定,创面闭合及肢体均衡等,简化并缩短治疗过程,减少并发症,从而提高了疗效.

锁骨骨折在临床上较常见，传统的治疗方法，如复位不当常导致畸形愈合，从而影响美观，并且有潜在血管、神经损伤的危险。我院自1994年6月至2001年10月共收治移位性锁骨骨折94例，经手术治疗后效果满意，现报道如下。……

Objective To provide clinical and experimental basis for the V-Y tendoplasty for the treatment of chronic achilles tendon rupture and describe the surgical techniques. Methods Seventy-three NewZealand white rabbits, in which chronic achilles tendon rupture model were established previouly, were treated with V-Y tendoplasty and Lindholm procedure. Postoperative histological studies and biomechanical test were carried out. Twelve patients who had a torn achilles tendon for an average of 135 days were treated with V-Y tendoplasty. The mean period of follow up was 6.5 years. The long term result was assessed with Arner-Lindholm method and radiological, ultrasonic examination were also performed. Results 1)The experimental studies showed that blood circulation of achilles tendon were not affected after the V-Y tendoplasty. The postoperative biomechanical characteristics of achilles tendon were more favorable than that of Lindholm procedure's. 2)According to Arner-Lindholm criteria 10 patients had the excellent results (83.3%), 2 patients had good results (16.7%). The percentage of excellent and good results were 100%. 3)The postoperative radiological and ultrasonic test results showed that there was overall thickening of whole achilles tendon. The array of tendon fibres was nearly normal. Calcification of achilles tendon were found in 2 patients. Conclusion V-Y tendoplasty might be a procedure of choice to treat chronic achilles tendon rupture.