外固定支架在严重多发伤合并闭合性长管骨骨折分期治疗中的应用

摘要

目的：探讨外固定支架分期治疗严重多发伤合并四肢闭合性长管骨骨折的临床疗效。方法笔者选取2009年1月～2013年8月收治的58例严重多发伤合并闭合性四肢长管骨骨折早期行单臂支架临时外固定的患者，男性39例，女性19例；年龄18～70岁，平均47岁。待全身病情稳定、局部软组织损伤改善后，再根据患者具体情况选择最终确定性内固定治疗。结果平均外固定支架使用时间6d。二期确定性内固定治疗前2例出现钉道感染。内固定术后随访时间3～18个月，平均5．2个月。术后切口3例出现感染，总体感染率为5．2％。结论早期采用临时外固定支架没有增加最终确定性内固定手术后感染率，有利于闭合性长管骨骨折进一步治疗。%Objective To evaluate the treatment effect of a staged protocol involving temporary external fix-ation and delayed definitive fixation in the management of closed long bone fractures with severe multiple trauma. Methods Retrospective review of 58 patients with closed long bone fracture underwent immediate temporary exter-nal fixation between Jan.2009 and Aug.2013 was carried out.There were 39 males and 19 females,with a mean age of 47 years ( ranged from 18 to 70 years) .Definitive fixations were based on the general conditions of specific patients after the stabilization of general condition and the status of local soft tissue.Results The average interval between external fixation and definitive internal fixation was 6 days.The pin tract infection occurred in 2 patients before internal fixation.The mean time for postoperative follow-up was 5.2 months(ranged from 3 to 18 months). The overall rate of surgical site infection after definitive internal fixation was 5.2%(3 out of 58) .Conclusion Im-mediate temporary external fixation did not increase the risk of postoperative infection after definitive fixation and provided groundwork for the further treatment of the closed long bone fractures.