摘要
目的:了解多发骨折中内固定治疗的意义。方法:系统回顾1980年1月～1995年11月间手术治疗的多发骨折患者188例,对499处骨折中的249处进行了内固定治疗,分析了多发骨折的常见部位、合并损伤及术后并发症。结果:1周内及1周后手术治疗分别为85例和103例,前者术后肺炎、褥疮等并发症发生率低于后者,且平均住院日明显缩短。45处开放骨折行Ⅰ期清创内固定15处,2例发生感染。用带锁髓内钉治疗开放性长骨干骨折4例,无感染发生。结论:多发骨折早期内固定的时间,应视患者受伤程度、并发症类别、医院的器械设备及术者技术水平而定。在大的综合医院,当患者生命体征平稳后,应争取在24小时内手术内固定。在设备条件较差的基层医院,应尽量创造手术条件,争取在1周内进行。开放性骨折Ⅰ期内固定的前提是有效彻底的清创。带锁髓内钉不仅可用于闭合性长骨骨折,在开放性骨折中亦得到了适当应用。
Aim:To understand the significance of internal fixation in the treatment of multiple fractures.Methods: Between Jan.1980-Nov.1995,188 patients with multiple fracture(499 fractures)treated with operation were re- viewed.Of the 499,249 fractares were managed with internal fixation.The parts vulnerabl to fracture,combined with injury,postoperation complications and the length of hospital stay were analysed.Results:Eighty-five patients were op- erated on within the first week of fracture and 103 patients one week after injury.The incidence of complications after operation,such as pneumonia and bed sore in the 85 pationts was much lower than in the 103 patients,and the average hospital stay shortened in the 85 compared with the 103 patients,(P<0.05).Among 45 open fractures,15 were treat- ed with primary debridement and internal fixation.Two of the 15 had infection.No infection happened in the 4 open fractures of long bones treated with intramedullary interlocking nails.Conclusion:In the multiple fracture patients, the internal fixation should be performed in the first 24 hours if good operating conditions are aviable. In poorly-equi-ped hospitals,operation should be performed with in the first week of injuries.For open fractures,stage I internal fixation should be performed after complete and timely debridement.Intramedullary interlocking nail can be used not only in closed fracture patients,but also in open fracture patients.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
1996年第5期277-279,共3页
Chinese Journal of Trauma
