外固定支架治疗严重多发伤合并四肢闭合性长管骨骨折疗效研究  

Study of efficacy of Treatment of Severe Multiple Injuries With Closed Long Tube Bone Fractures of Limbs With External Fixator

作　　者：张雷鸣 ZHANG Leiming(Second Department of Orthopedics,Songyuan Jilin Oilfield Hospital,Songyuan Jilin 138000,China)

机构地区：[1]松原吉林油田医院骨二科,吉林松原138000

出　　处：《中国继续医学教育》2021年第32期143-146,共4页China Continuing Medical Education

摘　　要：目的观察严重多发伤合并四肢闭合性长管骨骨折外固定支架分期治疗的疗效及预后。方法回顾性选取2018年1月—2020年1月本院骨科严重多发伤合并四肢闭合性长管骨骨折患者100例,依据手术方法分为外固定支架组(n=50)、常规内固定组(n=50)两组,统计分析两组患者的骨折恢复情况、切口愈合情况、骨折愈合时间、术后并发症发生情况、死亡情况。结果在骨折恢复的优良率方面,外固定支架组为90.0%(45/50),常规内固定组为74.0%(37/50),前者明显高于后者(P<0.05)。外固定支架组患者的切口一期愈合率96.0%(48/50)明显高于常规内固定组80.0%(40/50)(P<0.05),延期愈合率4.0%(2/50)明显低于常规内固定组20.0%(10/50)(P<0.05),骨折愈合时间明显短于常规内固定组(P<0.05)。在术后并发症发生率方面,外固定支架组为10.0%(5/50),常规内固定组为36.0%(18/50),前者明显低于后者(P<0.05)。在死亡率方面,外固定支架组为4.0%(2/50),常规内固定组为20.0%(10/50),前者明显低于后者(P<0.05)。结论严重多发伤合并四肢闭合性长管骨骨折外固定支架分期治疗的疗效及预后较常规内固定好。Objective To observe the curative effect and prognosis of severe multiple trauma combined with closed long bone fracture of extremities treated by external fixator by stages.Methods 100 patients with severe multiple injuries complicated with closed long bone fracture of limbs in our hospital from January 2018 to January 2020 were retrospectively selected and divided into external fixation group(n=50)and conventional internal fixation group(n=50)according to the operation methods.The fracture recovery,incision healing,fracture healing time,postoperative complications and death of the two groups were statistically analyzed Situation.Results The excellent and good rate of fracture recovery was 90.0%(45/50)in the external fixation group and 74.0%(37/50)in the conventional internal fixation group,the former was significantly higher than the latter(P<0.05).The primary wound healing rate of 96.0%(48/50)in the external fixation group was significantly higher than 80.0%(40/50)in the conventional internal fixation group(P<0.05),and the delayed healing rate was 4.0%(2/50)significantly lower than that in the conventional internal fixation group 20.0%(10/50)(P<0.05),and the fracture healing time was significantly shorter than that in the conventional internal fixation group(P<0.05).The incidence of postoperative complications was 10.0%(5/50)in the external fixation group and 36.0%(18/50)in the conventional internal fixation group.The former was significantly lower than the latter(P<0.05).In terms of mortality,the external fixation group was 4.0%(2/50)and the conventional internal fixation group was 20.0%(10/50),the former was significantly lower than the latter(P<0.05).Conclusion The curative effect and prognosis of staged external fixation are better than those of conventional internal fixation in the treatment of severe multiple trauma complicated with closed long bone fracture of extremities.

关 键 词：严重多发伤 四肢闭合性长管骨骨折 外固定支架 分期治疗 疗效 预后 

分 类 号：R681[医药卫生—骨科学]