股骨骨折术后隐性感染的临床特点及治疗  

CLINICAL FEATURES AND TREATMENT OF INAPPARENT INFECTION AFTER INTERNAL FIXATION OF FEMUR FRACTURE

作　　者：孔志刚[1] 于海泉[1] 

机构地区：[1]河北医科大学第三医院骨伤科,河北石家庄050051

出　　处：《河北医科大学学报》2008年第4期537-540,I0005,共5页Journal of Hebei Medical University

基　　金：河北省卫生厅科研基金项目(编号07080)

摘　　要：目的探讨股骨骨折内固定术后隐性感染的临床特点及处理方法。方法对12例股骨骨折内固定术后隐性感染患者的X线检查结果进行分析,选择恰当的处理方法。12例股骨骨折内固定术后隐性感染的患者,采用病灶清除,灌洗引流,其中9例取出内固定物改外固定架固定。术后应用抗生素2~3周。结果经10~48个月,平均23.5个月随访。骨折完全愈合10例,部分愈合1例,不愈合1例。1例出现窦道,2例感染复发。结论股骨骨折内固定术后隐性感染常存在骨缺损,骨折不愈合或愈合不良,需要手术治疗。感染轻者病灶清除后可保留内固定物。感染重或内固定物松动者行病灶清除同时取出内固定物改外固定架固定。X线表现是诊断股骨骨折内固定术后隐性感染的重要依据。发射型计算机断层扫描检查对了解感染范围,确定治疗方法有一定价值。Objective To study the clinical features and treatment of inapparent infection after the internal fixation of femur fracture. Methods The radiographic changes of 12 patients with inapparent infection after the internal fixation of femur fracture were analysed to choose a suitable approach. All the patients were treated with irrigation after debridment. Nine cases were dislodged internal fixation and then were fixed with external fixation among the 12 cases. Two cases preserved the internal fixation and were instilled after debridment. All of the patients were given antibiotics for 243 weeks after operation. Results All the 12 patients were followed up. The follow-up ranged from 10 to 48 months with an average of 23.5 months. Among the 12 cases 10.cases had bony union, 1 case partial union and 1 case nonunion. One case had fistula and infection relapsed in 2 cases. Conclusion Bone defects, fracture nonunion or delayed union often occur on patients who have inapparent infection after internal fixation of femur fracture. These patients should be operated. Fracture with slight infection can preserv internal fixation after debridment. Fractures with serious infection have to dislodge internal fixation and be fixed with external fixation after debridment. The diagnosis of inapparent infection after internal fixation of fracture could be made according to its radiographic changes. Emission computed tomograpy have a certain value for understanding the size of infection and treatment methods to determine.

关 键 词：内固定器 感染 骨折 不愈合 

分 类 号：R683.42[医药卫生—骨科学]