四肢长骨开放性骨折早期内固定治疗的探讨

Analysis of Early Internal Fixation for Treatment of Long Bone Open Fracture in Extremities

目的探讨早期内固定系统治疗四肢长骨开放性骨折的临床效果。方法86例四肢长骨开放性骨折患者，采用早期彻底清创，切开复位内固定治疗，其中采用钢板螺钉57例，髓内钉加钢丝14例，克氏针加钢丝10例，钢丝加外固定支架5例。Ⅰ期缝合65例，延迟缝合10例，皮瓣转移11例。结果随访77例，平均10.5（3-22）个月，骨正常愈合73例，延迟愈合或骨不连4例。结论早期内固定治疗四肢长骨开放性骨折能尽量把开放性骨折转变为闭合性骨折，从而提高其愈合能力。

Objective To discuss the effect of early internal fixation for treatment of long bone open fracture in extremities.Methods 86 cases of long bone open fracture in extremities were underwent thorough debridement,open reduction and internal fixation.The internal fixators were plate and screw in 57 cases,intramedullary nail and steel-wire in 14,kirschner wire and steel-wire in 10,steel-wire and external fixator in 5 cases.65 cases were underwent Ⅰ stage suture,10 receive delayed suture,and 11 were performed flap transfering.Results 77 cases were followed up for average 10.5 months（range from 3 to 22 months）.73 cases healed and 5 cases delayed union or nonunion.Conclusion Early internal fixation can enhance the bone healing for long bone fractures in extremities.