治愈濒于截肢的小腿辗砸伤8例报告  

SEVERE OPEN TIBIAL AND FIBULAL FRACTURES: REPORT OF 8 CASES

作　　者：毛宾尧[1] 盖维缤[1] 牛家度[1] 王道谦[1] 房清敏[1] 

机构地区：[1]滨州医学院附属医院骨科

出　　处：《滨州医学院学报》1991年第2期25-28,95,共4页Journal of Binzhou Medical University

摘　　要：报告8例严重的开放性胫腓骨骨折,均并有创伤性休克和败血症。其中伴发急性呼吸功能障碍(ARFF)和急性肾功能障碍(AKF)各5例,有4例合并其它部位骨折。按Gustilo分类,Ⅲ_B型5例,Ⅲ_c型3例。经早期急救处理,双管灌洗、三段悬吊或鸟笼式石膏悬吊牵引,均保留了肢体。8例中5例经植骨愈合,3例骨不连。深部软组织和骨感染全部痊愈。作者强调应严格初期处理、掌握截肢指征。Eight Type Ⅲ-cases of open tibial and fibulal fractures are reported, of which five are Type Ⅲ_B and three are Type Ⅲ_C. There were four severe complications, which were traumatic shock(8 patients),septicemia(8 patients),acute respiratory function failure (5 patients) and acute kidney failure (5 patients) in this group. The initial debridement,double-tube lavage and drainage,hanging traction of three parts and hanging traction of birdcage-like cast were applied in treatment. Of the eight fractures, five healed by bone graft and three were non-union. The eight patients were associated with deep infections,which were cured completely. They all have avoided amputation to date. The initial treatment and indication of amputation were discussed in this paper. The authors consider that the indication of amputation must be controlled strictly.

关 键 词：截肢 小腿辗砸伤 截肢指征 

分 类 号：R687.5[医药卫生—骨科学]