早期显微外科修复联合延期骨延长技术在GustiloⅢc型开放性骨折中的治疗体会  

Experience of early microsurgical repair combined with delayed bone lengthening in treatment of type Gustilo open fracture of type C

作　　者：梁波[1] 陈劲[1] 陈广谋 钟华[1] 肖刚[1] 阮国强[1] 马肃霜[1] LIANG Bo CHEN Jin CHEN Guang - mou et al(Trauma department of orthopedics, The Zhanjiang People＇ Central Hospital, Guangdong 524037, Chin)

机构地区：[1]湛江中心人民医院创伤骨科,广东湛江524037

出　　处：《中国伤残医学》2017年第20期10-12,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：探讨早期应用显微外科技术修复联合延期骨延长技术重建肢体长度在GustiloⅢc型开放性骨折中的疗效,为提高该类创伤救治的成功率提供依据.方法：回顾分析我科2013年9月-2015年8月收治获得随访的GustiloⅢc型开放性骨折患者9例.患者入院后,全身情况稳定后,行彻底清创,对有条件保肢患者,1期均进行骨折端缩短以缩小创面及降低骨感染的发生率,用简单外固定支架妥善固定骨折,1期修复合并的主干血管损伤,并在条件许可下尽可能修复肌腱及神经的损伤.结果：本组9例患者,7例保全肢体,最终创面及骨折愈合,保肢外形和功能患者基本满意;2例延期截肢,其中1例胫骨骨折患者中途中止治疗,到外院行截肢手术.结论：早期显微外科修复联合延期骨延长技术在GustiloⅢc型开放性骨折的治疗中显著的疗效,不仅可挽救肢体,保留长度,最大限度保留肢体的功能,而且可以降低骨髓炎的发生.Objective： To investigate the effect of microsurgical technique in the repair of open fracture of Gustilo type C with the ex- tension of bone lengthening technique in order to provide the basis for improving the success rate of this kind of trauma. Methods： a retro- spective analysis of 9 patients with Gustilo type C open fracture in our hospital from September 2013 to August 2015 were retrospectively analyzed. After admission, the patientg condition was stable and complete debridement, The patients conditions allow limb salvage, the first period were shortened bone at the fracture to reduce wound and reduce the incidence of bone infection, used a simple external fixator to properly fix the fracture, at the same time, repaired the damage of the main blood vessels, and repaired the tendon and nerve damage as much as possible. Results： The group of 9 patients, 7 cases wound and fracture healing eventually, patients were satisfied with limb appearance and function; 2 eases of delayed amputation, 1 eases of tibia] fracture patient was terminate treatment, amputation in other hospi- tal. Conclusion： Early stage microsurgical repair combined with delayed bone lengthening in tile treatment of Gustilo C type of open frac- ture had a significant effect, not only could save the limb, reserved length, maximum retention of limb function, but ＇also conld reduce the occurrence of osteomyelitis.

关 键 词：显微外科 延期骨延长 GustiloⅢc型开放性骨折 

分 类 号：R683[医药卫生—骨科学]