应用损害控制策略治疗下肢多发性骨折

Application of damage control strategy to treat multiple fractures in lower limb

目的探讨应用损害控制策略治疗下肢多发性骨折的作用。方法从2004年1月-2008年12月,32例下肢多发性骨折患者应用损害控制策略进行治疗,对其临床效果进行回顾性分析。结果全部患者无死亡,2例因伤情严重而截肢,2例多发伤患者出现急性肾功能衰竭,1例出现肺部感染,2例开放伤患者出现创面感染,经治疗病情稳定后行Ⅱ期手术,效果良好。1例发生骨不连,经再次手术后骨折愈合,5例有膝、踝关节活动受限。结论损害控制技术主要应用于严重多发伤的救治,而将其应用于下肢多发性骨折的治疗,有利于减少并发症的发生,提高救治成功率。

Objective To explore the effects of damage control strategy in treating multiple fractures of lower limbs. Methods Totally 32 cases of multiple fractures in lower limbs were treated with damage control strategy during the period of Jan. 2004 to Dee. 2008 and the clinical effects were retrospectively analyzed. Results No dead cases （ among all patients ） were found. There were 2 cases with limb amputation due to serious injuries. Two cases with multiple injuries had acute renal failure;1 case had pulmonary infection;2 cases of open trauma suffered from wound surface infection and had secondary surgery when the patientg condition was stable and the surgery was effective ; 1 case had bone nonunion and accepted secondary surgery, after which the fracture healed ; movement restriction of knee and ankle joint occurred in 5 cases. Conclusion Damage control strategy is mainly applied to severe multiple injury cases and its application in treating multiple fractures in lower limbs has the advantages of reducing complication occurrence and improving success rate.