中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
z1期
46-48
,共3页
赖志军%郭汉明%谢惠缄%康明%王新光%陈民%巫洪波
賴誌軍%郭漢明%謝惠緘%康明%王新光%陳民%巫洪波
뢰지군%곽한명%사혜함%강명%왕신광%진민%무홍파
多发伤%损害控制骨科%股骨骨折%手术治疗
多髮傷%損害控製骨科%股骨骨摺%手術治療
다발상%손해공제골과%고골골절%수술치료
Blunt multiple trauma%Damage control orthopedics%Femoral shaft fractures%Operative treatment
目的 对比两种方法治疗多发伤合并股骨干骨折的效果.方法 多发伤合并股骨干骨折患者148例,75例入院24h内采用石膏托外固定,病情稳定后行带锁髓内钉内固定；73例患者采用外固定架固定股骨干骨折二期行扩髓带锁髓内钉治疗.结果 石膏托固定组75例中71例获得随访,随访时间26.4个月,有18例发生多器官功能不全,26例发生成人呼吸窘迫综合征,骨折平均愈合时间5.9个月,3例骨不连,4例伤口感染,平均膝关节活动度107°(60～110°).外固定架固定组73例有68例获得随访,随访时间27.5个月,有13例发生多器官功能不全,12例发生成人呼吸窘迫综合征,骨折平均愈合时间5.6个月,2例骨不连,3例伤口感染,平均膝关节活动度120°(60 ～ 140°).结论 采用损害控制骨科治疗多发伤合并股骨干骨折比石膏固定组有较低的多器官功能不全、成人呼吸窘迫综合征的发生率,且病死率低,骨折愈合快,感染率低,患肢功能恢复好.
目的 對比兩種方法治療多髮傷閤併股骨榦骨摺的效果.方法 多髮傷閤併股骨榦骨摺患者148例,75例入院24h內採用石膏託外固定,病情穩定後行帶鎖髓內釘內固定；73例患者採用外固定架固定股骨榦骨摺二期行擴髓帶鎖髓內釘治療.結果 石膏託固定組75例中71例穫得隨訪,隨訪時間26.4箇月,有18例髮生多器官功能不全,26例髮生成人呼吸窘迫綜閤徵,骨摺平均愈閤時間5.9箇月,3例骨不連,4例傷口感染,平均膝關節活動度107°(60～110°).外固定架固定組73例有68例穫得隨訪,隨訪時間27.5箇月,有13例髮生多器官功能不全,12例髮生成人呼吸窘迫綜閤徵,骨摺平均愈閤時間5.6箇月,2例骨不連,3例傷口感染,平均膝關節活動度120°(60 ～ 140°).結論 採用損害控製骨科治療多髮傷閤併股骨榦骨摺比石膏固定組有較低的多器官功能不全、成人呼吸窘迫綜閤徵的髮生率,且病死率低,骨摺愈閤快,感染率低,患肢功能恢複好.
목적 대비량충방법치료다발상합병고골간골절적효과.방법 다발상합병고골간골절환자148례,75례입원24h내채용석고탁외고정,병정은정후행대쇄수내정내고정；73례환자채용외고정가고정고골간골절이기행확수대쇄수내정치료.결과 석고탁고정조75례중71례획득수방,수방시간26.4개월,유18례발생다기관공능불전,26례발생성인호흡군박종합정,골절평균유합시간5.9개월,3례골불련,4례상구감염,평균슬관절활동도107°(60～110°).외고정가고정조73례유68례획득수방,수방시간27.5개월,유13례발생다기관공능불전,12례발생성인호흡군박종합정,골절평균유합시간5.6개월,2례골불련,3례상구감염,평균슬관절활동도120°(60 ～ 140°).결론 채용손해공제골과치료다발상합병고골간골절비석고고정조유교저적다기관공능불전、성인호흡군박종합정적발생솔,차병사솔저,골절유합쾌,감염솔저,환지공능회복호.
Objective To compare the effect of two different treatment approaches on femoral shaft fractures in polytrauma patients.Methods One hundred and forty-eight polytrauma patients were selected as our subjects,who were hospitalized from Jan.2000 to Dec.2009.They were randomly divided into cast group and external fixation group.Patients in cast group were fixed with cast within the first 24 h after the injury and patients in external fixation group were stabilized with a unilateral external fix stent within the first 24 h after the injury.Results In cast group,71 of 75 patients were followed up and follow up periods was 26.4 months.Follow up data showed that 18 patients developed multiple organ failure (MOF) and 26 patients developed ARDS.The average healed periods was 5.9 month.Three patients developed nonunion and 4 cases developed wound infection.The average of the knee motion angle was 107 degrees (60 to 110 degrees).In external fixation group,68 patients were followed up and the follow-up period was 27.5 months.Of which,13 patients developed MOF and 12 patients developed ARDS.The average healed periods was 5.6 months.2 patients developed nonunion and 3 cases developed for.wound infection.The average of the knee motion angle was 120 degrees (60 to 140 degrees).Conclusion The damage control orthopedics surgery was proved as a safe and effective treatment approach for fractures of the shaft of the femur in selected multiply injured patients compared with cast methods.
