Observation of the effect of external fixator combined with limited internal fixation in the treatment of adolescents distal tibial fracture involving the metaphysis

Objective To evaluate the clinical indications, complications and curative effects of external fixation combined with limited internal fixation in the treatment of adolescents distal tibial fracture involving the metaphysis. Methods From February 2013 to June 2017, 18 adolescent patients of distal tibial fracture involving stem epiphyseal in Luzhong Hospital of Beida Care were treated with external fixator combined with limited internal fixation.All 18 cases were closed fractures, according to Salter-Harris classification: type Ⅱ 8 cases, type Ⅲ 8 cases, type Ⅳ 2 cases.The fracture healing time, postoperative patients with limb full weight-bearing time, postoperative ankle function grading, postoperative incision of the skin, deep tissue and nail complications such as infection were observed. Results All patients received postoperative 12 to 24 months follow-up, with average of 16 months, the average postoperative fracture healing time was (8.4±3.2)weeks, the full load time of affected limb after operation was average (8.8±2.2)weeks, the ankle joint function score according to Kofoed score: 6 weeks after operation, Kofoed score was (86.6±6.8)points, excellent in 15 cases, good in 3 cases, and the excellent and good rate was 100%, 1 case with nail way out at postoperative 1 week, after the demolition of external fixator nail healed, no other blade and deep infection and other complications occurred. Conclusion The external fixation combined with limited internal fixation in the treatment of adolescents distal tibial fracture involving the metaphysic can avoid fracture end blood supply damage caused by open surgery, it is quick with small incision, fracture healing, fewer complications, and the advantages of ankle joint function restore is good, has good clinical therapeutic effect. Key words: Tibial fractures; Epiphyses; Fracture fixation, internal; External fixators; Adolescent