外固定支架在急诊严重开放性胫腓骨折治疗中的应用  

EXTERNAL FIXATOR APPLICATION IN THE EMERGENCY TREATMENT OF SEVERE OPEN FRACTURES OF THE TIBIA AND FIBULA

作　　者：高超 成业东 王加波 冯海波 王昌超 姜鹏 

机构地区：[1]解放军第八十二医院骨四科,江苏省淮安市223001

出　　处：《中国煤炭工业医学杂志》2015年第4期603-605,共3页Chinese Journal of Coal Industry Medicine

摘　　要：目的对急诊中应用外固定支架治疗开放性胫腓骨折的临床效果进行探讨与分析。方法选取2010年12月-2012年12月在该院急诊接受治疗的严重开放性胫腓骨折患者78例，对患者的临床资料进行回顾性分析，所有患者进过彻底的清创处理后均使用孟和全环式外固定架进行外固定治疗，并对患者治疗后的恢复情况以及不良反应情况进行观察。结果经过1～2年的随访调查，78例患者中有69例行单纯外固定架治疗患者达到骨性愈合标准，平均愈合时间为28周；9例患者在进行外固定支架治疗6个月后将外固定架拆除对患者进行钢板内固定术以及自体髂骨植骨术后达到骨性愈合标准，平均的愈合时间为36周，骨折愈合率为88．46％；3例出现针孔处的感染和松动，感染率为3．85％；未见骨折畸形愈合，再断裂以及继发性骨髓炎。结论急诊中应用外固定支架治疗开放性胫腓骨折的临床效果显著，值得临床应用和推广。Objective To explore the application for the emergency treatment of external fixation of open fractures of the tibia and fibula. Methods A total of 78 cases were selected as research subjects from De- cember 2010 to December 2012 in author＇s hospital during the emergency treatment of patients with severe open fractures of the tibia and fibula, the patient＇s clinical data were analyzed retrospectively. All patients who had a thorough debridement were treated with Meng and full ring external fixation, the recovery of pa- tients after treatment and adverse reactions were observed. Results After 1 to 2 years of follow- up sur- vey, 78 patients had 69 routine simple external fixator patients achieved bony union, the average healing time was 28 weeks; another 9 patients during external fixation after 6 months of treatment the removal of the external fixator patients with plate fixation and autogenous iliac bone graft bone healing after reaching the standard, the average healing time was 36 weeks, fracture healing rate was 88.46 %. Although three ca- ses appeared infection and loosening at a pinhole, infection rate was 3.85%. But there were no malunion, broken again and secondary asteomyetitis. Conclusion The application of external fixation emergency in the treatment of open fractures of the tibia and fibula is significant effect, it is worthy of application and promotion in clinic.

关 键 词：Ⅲ度开放性骨折 外固定支架 胫腓骨折 感染 

分 类 号：R683[医药卫生—骨科学]