中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2014年
11期
946-950
,共5页
黄雷%田金翌%杨涛%黄凯%王满宜
黃雷%田金翌%楊濤%黃凱%王滿宜
황뢰%전금익%양도%황개%왕만의
胫骨%骨折,开放性%骨延长术%骨缺损%流行病学
脛骨%骨摺,開放性%骨延長術%骨缺損%流行病學
경골%골절,개방성%골연장술%골결손%류행병학
Tibia%Fractures,open%Bone lengthening%Bone defect%Epidemiology
目的 了解创伤晚期胫骨缺损的诱因、易感人群及多次手术的原因,以期提出有效的预防措施.方法 回顾性分析2009年3月至2013年3月期间采用骨搬运术治疗的创伤晚期胫骨缺损患者资料,设计表格,收集并统计相关数据,对患者一般情况、受伤情况及治疗情况加以分析.结果 共统计94例胫骨缺损患者,男86例,女8例,男女比为10.8∶1.患者来自20个省、自治区及直辖市,其中56.4％ (53/94)来自河北省、内蒙古自治区和辽宁省;患者主要为体力工作者;交通伤是主要致伤原因;患者以21 ～ 50岁年龄段为主,占78.7％ (74/94).开放性损伤占93.6％ (88/94),54.3％(51/94)的患者存在合并伤.首诊医院以三级甲等医院及二级甲等医院为主.伤后6h内就诊者占72.3％ (68/94).对于GustiloⅢC型胫骨开放性骨折,首诊手术仍有31.3％ (5/16)的患者采用内固定治疗.行骨搬运术前平均手术次数为(4.4±3.1)次.治疗费用平均为(16.1±9.9)万元,有61.7％ (58/94)的患者自费.结论 胫骨开放性骨折的主要致伤原因是交通伤,其晚期胫骨缺损的治疗非常棘手,骨科医生应重视正确掌握开放性骨折的治疗原则,提高治疗水平.
目的 瞭解創傷晚期脛骨缺損的誘因、易感人群及多次手術的原因,以期提齣有效的預防措施.方法 迴顧性分析2009年3月至2013年3月期間採用骨搬運術治療的創傷晚期脛骨缺損患者資料,設計錶格,收集併統計相關數據,對患者一般情況、受傷情況及治療情況加以分析.結果 共統計94例脛骨缺損患者,男86例,女8例,男女比為10.8∶1.患者來自20箇省、自治區及直轄市,其中56.4％ (53/94)來自河北省、內矇古自治區和遼寧省;患者主要為體力工作者;交通傷是主要緻傷原因;患者以21 ～ 50歲年齡段為主,佔78.7％ (74/94).開放性損傷佔93.6％ (88/94),54.3％(51/94)的患者存在閤併傷.首診醫院以三級甲等醫院及二級甲等醫院為主.傷後6h內就診者佔72.3％ (68/94).對于GustiloⅢC型脛骨開放性骨摺,首診手術仍有31.3％ (5/16)的患者採用內固定治療.行骨搬運術前平均手術次數為(4.4±3.1)次.治療費用平均為(16.1±9.9)萬元,有61.7％ (58/94)的患者自費.結論 脛骨開放性骨摺的主要緻傷原因是交通傷,其晚期脛骨缺損的治療非常棘手,骨科醫生應重視正確掌握開放性骨摺的治療原則,提高治療水平.
목적 료해창상만기경골결손적유인、역감인군급다차수술적원인,이기제출유효적예방조시.방법 회고성분석2009년3월지2013년3월기간채용골반운술치료적창상만기경골결손환자자료,설계표격,수집병통계상관수거,대환자일반정황、수상정황급치료정황가이분석.결과 공통계94례경골결손환자,남86례,녀8례,남녀비위10.8∶1.환자래자20개성、자치구급직할시,기중56.4％ (53/94)래자하북성、내몽고자치구화요녕성;환자주요위체력공작자;교통상시주요치상원인;환자이21 ～ 50세년령단위주,점78.7％ (74/94).개방성손상점93.6％ (88/94),54.3％(51/94)적환자존재합병상.수진의원이삼급갑등의원급이급갑등의원위주.상후6h내취진자점72.3％ (68/94).대우GustiloⅢC형경골개방성골절,수진수술잉유31.3％ (5/16)적환자채용내고정치료.행골반운술전평균수술차수위(4.4±3.1)차.치료비용평균위(16.1±9.9)만원,유61.7％ (58/94)적환자자비.결론 경골개방성골절적주요치상원인시교통상,기만기경골결손적치료비상극수,골과의생응중시정학장악개방성골절적치료원칙,제고치료수평.
Objective To analyze the causes for injury and secondary surgery and susceptible population of late traumatic tibial defect.Methods The patients who had been treated for late traumatic tibial defect with bone transport using Orthofix Limb Reconstruction System (LRS) from March 2009 to March 2013 were retrospectively studied.The clinical data including general information,injury conditions and treatment were collected and analyzed statistically.Results Altogether 94 patients with late traumatic tibial defect were included.They were 86 men and 8 women,giving a male to female ratio of 10.8∶ 1.They came from 20 different provinces.56.4％ of them (53/94) came from Inner Mongolia Autonomous Region,Hebei and Liaoning provinces.Most patients were physical laborers.Most injuries were caused by a traffic accident.78.7％ of the patients(74/94) were aged from 21 to 50 years old.93.6％ of the injuries (88/94) were open,and complicated injuries occurred in 54.3％ of the patients(51/94).Their original hospitals were mostly major medical institutions.72.3％ of the patients (68/94) had had their injury treated within 6 hours posttrauma.31.3％ of the tibial open fractures of type Gustilo Ⅲ C (5/16) were primarily treated with internal fixation.The operations before bone transport averaged 4.4 ± 3.1 times and cost of treatment 161,000 ± 99,000 Yuan.61.7％ of the patients(58/94) paid their medical expenditures by themselves.Conclusions Traffic safety is of great importance for prevention of a late traumatic tibial defect.It is very challenging to treat late traumatic tibial defects.To improve the therapeutic efficacy,it is necessary for a surgeon to master the principles for treating open fractures.
