胫骨骨折交锁髓内钉固定术后感染的处理效果

Causes Analysis and Management of Postoperative Infection of Tibia Fracture Treated with Intramedullary Locking Nailing

目的总结胫骨骨折交锁髓内钉内固定术后感染处理效果. 方法 21例术后感染病例,其中急性感染6例,慢性感染15例,均予全身应用敏感抗生素并支持治疗,急性者予局部切开引流换药,保留髓内钉;慢性者行再次手术治疗,取出髓内钉,重新固定骨折端. 结果全部病例均获随访,平均15(6～24)个月,感染均被控制,未见复发,骨折愈合. 结论选择敏感抗生素,彻底清创,根据感染的程度和骨折愈合的情况决定保留或取出内固定,使骨折端获得固定等综合治疗方法,可使交锁髓内钉术后感染获得满意的控制效果.

Objective To investigate the causes and management of postoperative infection of tibia fracture treated with intramedullary locking nailing. Methods: 21 cases were analyzed restrospectively including 6 cases of acute infection who underwent excision and drainage with retention of intramedullary nail, 15 cases of chronic infection who underwent removing of nail and refixation. All patients treated with antibiotics and support therapy. Result All fracture united without recurrence with 6～24 months follow-up in all cases. Conclusion Infection can be controlled with sensitive antibiotics, complete debridment, and removing of internal fixation device when the condition of infection and facture healing requires.