Résumé
Objective To investigate the methods for emergency treatment of open tibial fractures of type ⅢB. Methods From February 1999 to February 2002, 16 cases of open tibial fractures of type ⅢB (age range: 19 47 years; average age: 27 years; the skin defect area: 4.5cm ?3cm-14cm ?6cm) were treated with administration of antibiotics, debridement, stabilization by unreamed locking intramedullary nails, and finally transfer or transplantation of cutaneous or musculo cutaneous flaps. Autografting from the iliac crest was done for 4 cases with bone defects. Results The follow ups averaged 9 months (ranging from 6 months to 14 months). The survival rate of flaps was 100%and all were free of deep infection. All fractures healed within 6 months in 14 patients and within 10 months in 2 patients. According to the Johner Wruchs method, the functions of ankle and knee were excellent in 14 cases, and good in 2 cases. Conclusion Emergency management of open tibial fractures of type ⅢB with unreamed locking intramedullary nails and skin flap grafting results in good outcome.