Ⅲb、Ⅲc型胫骨开放性骨折保肢与截肢的治疗选择  

Treatment Option of Salvage or Amputation in TypeⅢb、Ⅲc Open Tibial Fractures

作　　者：校佰平[1] 李明[1] 周龙[1] 张经纬[1] 王邦荣[1] 俞怡辉[1] 魏军渔[1] 罗建宁[1] 

机构地区：[1]浙江省宁波市第六医院创伤骨科,315040

出　　处：《中国骨与关节损伤杂志》2009年第10期875-876,共2页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨GustiloⅢb、Ⅲc型胫骨开放性骨折急诊手术中保肢与截肢治疗方法的选择。方法自2005年2月～2008年3月,共收治GustiloⅢb、Ⅲc型开放性骨折98例101个肢体;年龄18～67岁,其中Ⅲb型54肢,Ⅲc型47肢,急诊截肢32例,保肢治疗失败后延迟截肢7例,均采用Gustilo诊断分类及通用截肢技术予以处理。结果行保肢手术59例中有8例出现伤口感染,2例骨折部感染。所有早期及延迟截肢患者术后恢复良好。结论对GustiloⅢb、Ⅲc型胫骨开放性骨折的治疗,应进行严格的评判,根据清创术中的具体情况把握好最终手术治疗方式的选择,这也是现代创伤骨科医生必须面对的一个严肃的课题。Objective To explore the treatment option of salvage or amputation in Gustilo type Ⅲ b、Ⅲ c open tibial fractures. Methods From February 2005 to March 2008,101 cases （98 patients） of type Ⅲb、Ⅲc open tibial fractures were admitted. Type Ⅲb 54 cases, type Ⅲc 47 cases. Emergency amputation was performed in 32 cases and later amputation in 7 cases. The age varied from 18 to 67 years old. All the cases were treated with the modem surgical technique. Results Among the 59 salvage cases, infection occurred in 10 cases, and medical lawsuits in 2 cases. The results were good in all the amputated cases. Conclusion The careful examination, correct assessment and good surgical technique are key factors for a good traumalogist.

关 键 词：Gustilo分型 胫骨 开放性骨折 

分 类 号：R683.42[医药卫生—骨科学] R496[医药卫生—外科学]