外固定支架在四肢骨折中的应用  

Application of external fixator in limb fracture

作　　者：游小军[1] YOU Xiaojun(mining General Hospital of Jizhong Energy Sources Xingtai Mining Industry Group Limited-liability Company,Hebei,Xingtai 054000,China)

机构地区：[1]冀中能源邢台矿业集团有限责任公司总医院第16批援刚果(金)医疗队,河北省邢台市054000

出　　处：《河北医药》2020年第17期2618-2621,共4页Hebei Medical Journal

摘　　要：目的探讨外固定支架在中国刚果(金)中刚友谊医院四肢骨折中应用的临床疗效。方法回顾性分析2012年6月1日至2015年1月1日收治的300例四肢骨折患者,其中闭合性骨折230例,开放性骨折70例,所有患者采用外固定支架治疗。结果开放骨折均一期伤口给予清创缝合,二期手术给予外固定架固定,皮肤缺损,术后给予换药,大部分创面完全愈合,部分患者经植皮后创面愈合,患者均未行皮瓣修复。其中单平面单支架半针固定型213例,双平面双支架全针固定型35例,双平面双支架半针固定型40例,跨关节可调式外固定架12例。骨折愈合时间3~18个月,平均(6.81±1.36)个月;瑕疵愈合20例,其中更换外固定支架9例。闭合性骨折患者平均愈合时间、更换外固定支架比例和感染率分别为(5.10±1.23)个月、2.61%(6/230)和0.87%(2/230),开放性骨折患者上述指标分别为(8.00±1.56)个月,4.29%(3/70)和12.86%(9/70),闭合性骨折患者表现均优于开放性骨折患者(P<0.05)。开放骨折病例中,术后伤口出现感染9例,闭合性骨折出现2例;术后随访6~30个月,2例患者术后3个月因其他疾病去世。结论外固定架治疗四肢骨折,具有微创、简单、固定可靠的优点,在多战乱、医疗条件相对落后的地区是骨折治疗的首选,外固定选择组合式、跨关节外固定是刚果(金)友谊医院的发展趋势。Objective To investigate the clinical effects of external fixator in limb fracture.Methods A retrospective analysis was performed in 300 patients with limb fracture who were treated from June 1,2012 to January 1,2015,of whom,there were 230 cases of closed fractures and 70 cases of open fractures,all fracture patients were treated with external fixator.Results Open fracture was treated with debridement and suture in one stage,external fixator in the second stage,skin defect,dressing change after operation,most of the wounds healed completely,some of the wounds healed after skin grafting,and no flap repair was performed.Among them,213 cases were fixed with single plane single support half needle,35 cases were fixed with double plane double support full needle,40 cases were fixed with double plane double support half needle,and 12 cases were fixed with adjustable cross joint external fixator.The average healing time,the ratio of external fixation and the infection rate were(5.10±1.23)months,2.61%(6/230)and 0.87%(2/230),respectively.The above indexes were(8.00±1.56)months,4.29%(3/70)and 12.86%(9/70),respectively.The performance of closed fracture patients was better than that of open fracture patients(P<0.05).The patients were followed up for 6~30 months,the time of fracture healing was 3~18 months,with an average of(6.81±1.36)months;20 cases of defect healing,including 9 cases of external fixator replacement;9 cases of open fracture,9 cases of wound infection,2 cases of closed fracture;2 cases died of other diseases 3 months after operation.Conclusion The external fixator has the advantages of minimally invasive,simple and reliable fixation in treatment of limb fractures,thus,it is the first choice for fracture treatment in areas where war and medical conditions are relatively worse.

关 键 词：外固定支架 四肢骨折 闭合性骨折 开放性骨折 瑕疵愈合 治疗结果 

分 类 号：R683[医药卫生—骨科学]