外固定支架治疗5.12地震致严重胫腓骨开放骨折伤员效果评价
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摘要
目的探讨地震所致严重胫腓骨开放性骨折早期的处理方法与技巧,总结外固定支架治疗、稳定骨折端的临床效果。方法早期采用外固定支架治疗5.12地震所致严重胫腓骨开放性骨折伤员27例,男15例,女12例;年龄14~71岁,受伤时间5~26小时,按Gustilo分型,ⅢA 16例,ⅢB 9例,ⅢC 2例。结果25例骨折复位良好,2例因骨折复位不良,再次行骨折复位,外支架调整;肢体肿胀2~4天消退;无感染和II期截肢病例。手术时间40~70分钟,平均48分钟。结论地震所致严重胫腓骨开放性骨折早期以外固定支架为主,有利于软组织修复及肢体肿胀消退,便于稳定骨折、术后护理及后期转运。
Objective To explore early treatment and technique of serious open fractures of tibia and fibula with external fixation after 5.12 earthquake and to summarize the experience of treatment with external fixation.Methods The retrospective analysis were carried out in 27 cases of serious open tibial and fibula fractures.27 cases were treated with external fixation in early stage,among them 15 were male and 12 were female.The age ranged from 14~71 years with an average of 33.5 years.The time from injuried to treatment was 5~26 h with an average of 14.5 h.The fracture types were ⅢA 16,ⅢB 9,ⅢC 2 according to Gustilo typing.Results 25 patients achieved good reduction of facture,the external fixation was rejusted in 2 patients because of bad reduction,the limb swelling residing in 2~4 d,no patients was infected and amputated in later stage,the operation time was 40~70 min with an average of 48min.Conclusion Treatment with external fixation in early stage is simple,fast and effective method for serious open fractures of tibia and fibila in patients injuried in earthquake.It is helpful for soft tissue healing and limb swelling residing,and also helpful for nursing after operation or transfer at later time.
Objective To explore early treatment and technique of serious open fractures of tibia and fibula with external fixation after 5.12 earthquake and to summarize the experience of treatment with external fixation.Methods The retrospective analysis were carried out in 27 cases of serious open tibial and fibula fractures.27 cases were treated with external fixation in early stage,among them 15 were male and 12 were female.The age ranged from 14~71 years with an average of 33.5 years.The time from injuried to treatment was 5~26 h with an average of 14.5 h.The fracture types were ⅢA 16,ⅢB 9,ⅢC 2 according to Gustilo typing.Results 25 patients achieved good reduction of facture,the external fixation was rejusted in 2 patients because of bad reduction,the limb swelling residing in 2~4 d,no patients was infected and amputated in later stage,the operation time was 40~70 min with an average of 48min.Conclusion Treatment with external fixation in early stage is simple,fast and effective method for serious open fractures of tibia and fibila in patients injuried in earthquake.It is helpful for soft tissue healing and limb swelling residing,and also helpful for nursing after operation or transfer at later time.
引文
[1]刘云鹏,姜俊杰,王海.单侧纵轴动力外固定器治疗胫腓骨骨折所致骨延迟愈合的生物力学研究与临床[J].中华骨科杂志,1999,19(5):607-609.
[2]李山珠,袁峰,吴卫平,等.复杂开放性胫骨骨折的治疗[J].骨与关节损伤杂志,2003,18(3):180-182.
[3]Alberts KA,Loohagen G,Einarsdottir H.Open tibial fractures:faster u-nion after undreamed nailing than external fixation[J].Injury,1999,30(4):519-523.
[4]周来喜,许世存,郑廷忠,等.不扩髓交锁髓内钉治疗胫骨开放性骨折[J].中国矫形外科杂志,2003,11(9):595-597.
[5]张发平,王爱民,吴思宇,等.单臂外固定器治疗胫腓骨严重开放粉碎性骨折[J].中华创伤骨科杂志,2005,7(4):392-393.
[6]王选民,刘思杰,申才佳.外固定器伴自体骨及骨髓植入治疗肱骨干骨折不愈合[J].临床骨科杂志,2002,5(3):223-225.
[7]Marsh JL.Weekly pin-site care was as effective as daily care in patientswith external fixation[J].JBoneJointSurgAm,2004,86(8):1835-1839.
[2]李山珠,袁峰,吴卫平,等.复杂开放性胫骨骨折的治疗[J].骨与关节损伤杂志,2003,18(3):180-182.
[3]Alberts KA,Loohagen G,Einarsdottir H.Open tibial fractures:faster u-nion after undreamed nailing than external fixation[J].Injury,1999,30(4):519-523.
[4]周来喜,许世存,郑廷忠,等.不扩髓交锁髓内钉治疗胫骨开放性骨折[J].中国矫形外科杂志,2003,11(9):595-597.
[5]张发平,王爱民,吴思宇,等.单臂外固定器治疗胫腓骨严重开放粉碎性骨折[J].中华创伤骨科杂志,2005,7(4):392-393.
[6]王选民,刘思杰,申才佳.外固定器伴自体骨及骨髓植入治疗肱骨干骨折不愈合[J].临床骨科杂志,2002,5(3):223-225.
[7]Marsh JL.Weekly pin-site care was as effective as daily care in patientswith external fixation[J].JBoneJointSurgAm,2004,86(8):1835-1839.
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