一期内固定治疗Gustilo Ⅱ、ⅢA开放性尺桡骨骨折的疗效观察  

Efficacy of one-period fixation for Gustilo Ⅱ and ⅢA open ulnaand radius fractures

作　　者：李京玉 贾代良[1] 王海滨[1] 李笑颜[1] 吴彬[1] 姜振[1] LI Jingyu;JIA Dailiang;WANG Haibin;LI Xiaoyan;WU Bin;JIANG Zhen(Department of Emergency Surgery,Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]济宁医学院附属医院急诊外科,济宁272029

出　　处：《济宁医学院学报》2023年第6期425-429,共5页Journal of Jining Medical University

摘　　要：目的对一期行切开复位内固定手术治疗GustiloⅡ、ⅢA开放性尺桡骨骨折的疗效进行观察。方法回顾性分析2017年1月—2022年1月就诊我院经过我院行切开复位内固定手术治疗的GustiloⅡ、ⅢA开放性尺桡骨骨折患者42例,回访观察术后是否存在浅表感染、深部感染,骨折愈合情况和前臂功能恢复情况。结果获得随访3~13个月,平均4.3个月。共3例Ⅰ期未缝合创面出现浅表感染,经过多次清创感染控制,最终创面愈合,未出现深部感染。骨折均可见骨痂生长,对位、对线满意、无成角畸形。骨折愈合全部良好。骨折愈合后前臂功能评价优33例,满意7例,不满意2例。结论GustiloⅡ、ⅢA开放性尺桡骨骨折术前仔细评估开放骨折特点,术中经过彻底清创,使用一期切开复位内固定治疗方式,能获得满意的临床效果。其确切的固定效果有助于伤口愈合,患者早期功能锻炼,是开放性尺桡骨骨折可以选择的治疗方式。Objective To observe the efficacy of one-stage open reduction and internal fixation for GustiloⅡandⅢA open ulna and radius fractures.Methods Retrospective analysis was performed on the data of patients with open fractures of GustiloⅡGustiloⅢA of ulna and radius treated by open reduction and internal fixation surgery in our hospital from January 2017 to January 2022,and follow-up was conducted to observe whether there were superficial infection,deep infection,fracture healing and functional recovery of forearm after surgery.Results Follow-up was 3-13 months,with an average of 4.3 months.A total of 3 stage I unstitched wounds showed superficial infection,and wound healing was finally achieved after repeated debridement and infection control.There were 0 case of deep infection.Callus growth,contrapuntal,line satisfaction and angle-less deformity were seen in all fractures.The functional evaluation of fracture healing was excellent in 33 cases,satisfactory in 7 cases,unsatisfactory in 2 cases and poor in 0 case.Conclusion The characteristics of open fractures were carefully evaluated before GustiloⅡandⅢA open ulnar and radius fractures.After thorough debridement and one-stage open reduction and internal fixation,satisfactory clinical results could be obtained.Its exact fixation effect is helpful for wound healing,early functional exercise,and is an alternative treatment for open ulnar and radius fractures.

关 键 词：尺桡骨 开放性骨折 切开复位内固定 

分 类 号：R68[医药卫生—骨科学]