一期内固定联合负压封闭引流术在尺桡骨三度开放性骨折中的应用一期内固定联合负压封闭引流术在尺桡骨三度开放性骨折中的应用  

Application of anterior internal fixation plus vacuum sealing drainage in the treatment of ulnar and radial fractures of Gustilo type Ⅲ

作　　者：胡定祥[1] 林达强[1] 何芳[1] 郑瑞清[2] 

机构地区：[1]四川达州市中西医结合医院骨科,达州635000 [2]四川达州市中西医结合医院康复科,达州535000

出　　处：《国际外科学杂志》2014年第11期730-733,共4页International Journal of Surgery

摘　　要：目的探讨一期内固定联合负压封闭引流治疗在尺桡骨三度开放性骨折中的临床效果。方法回顾性分析2007年4月-2014年3月，达州市中西医结合医院骨科收治的28例尺桡骨三度开放性骨折患者，7例采用外固定架固定术后常规换药，设为A组；7例采用一期内固定联合负压封闭引流术，设为B组；7例采用外固定架固定联合负压封闭引流术，设为C组；7例采用一期内固定术后常规换药，设为D组。结果28例患者获电话随访6—27个月，平均9．8个月。皮肤软组织愈合时间：A组为（20．5±2．37）d，B组为（14．7±2．16）d，C组为（15．6±2．17）d，D组为（19．7±2．18）d；平均住院天数：A组为（9．7±2．54）周，8组为（4．7±1．46）周，c组为（5．2±2．34）周，D组为（8．6±2．16）周；骨折愈合时间：A组为（19．6±2．74）周，B组为（13．1±1．84）周，C组为（18．1±2．54）周，D组为（14．7±1．74）周。数据对比分析，B组优于A、C、D组（P〈0．05）。结论一期内固定联合负压封闭引流术治疗尺桡骨三度开放性骨折治疗周期短，并发症少，能有效减轻患者痛苦及治疗费用，是一较好的手术治疗方法。Objective To investigate the clinical effect of anterior internal fixation plus vacuum sealingdrainage in the treatment of ulnar and radial fractures of Gustilo type Ⅲ. Methods Twenty-eight patients with open ulnar and radial fracture of Gustilo type Ⅲ were managed from April 2007 to March 2014, and were divided into four groups （n = 4）. Group A were managed with external fixator and conventional changing dressings. Group B were managed with internal fixation and vacuum sealing drainage. Group C were man- aged with external fixator and vacuum sealing drainage. Group D were managed with internal fixation and conventional changing dressings. Result Twenty-eight cases were adopted telephone follow-up for 6 to 27 months. The soft tissue recovery time of each group respectively was （20.5 ＋ 2.37 ） days, （ 14.7 ＋ 2.16） days, （ 15.6 ± 2.17） days and（ 19.7 ± 2.18） days. The hospital stay of each group respectively was （9.7 ＋ 2.54） weeks, （4.7 ± 1.46） weeks, （ 5.2 ± 2.34） weeks and 8.6 ± 2.16） weeks. The fracture healing time of each group respectively was （ 19.6 ± 2.74 ） weeks, （ 13. 1 ± 1.84 ） weeks, （ 18. 1 ± 2.54） weeks and （14.7 ± 1.74） weeks. There was significant difference of these data between the two groups（ P 〈 0.05 ）. Conehmions Anterior internal fixation plus vacuum sealing drainage is a better way to treat ulnar and radial fractures of Gustilo type III. The technique has short period, less complications, less painful and less expense.

关 键 词：内固定 负压封闭引流术 尺骨骨折 桡骨骨折 开放性骨折 治疗应用 

分 类 号：R615[医药卫生—外科学]