枪伤致四肢长骨干粉碎性骨折一期修复的疗效分析

Analysis on the Curative Effect of 1-stage Repairment on Bone Fracture of Extremities Injured by Gunshot

目的探索枪伤致四肢长骨干严重粉碎性骨折一期修复的方法及疗效。方法18例枪伤致四肢长骨干严重粉碎性骨折,采用早期彻底清创,一期整复骨折,并采用自行设计的半环式梯形加压钢板固定。对合并的神经、血管损伤均予以一期修复。结果所有病例伤口均一期愈合。骨折随访时间5-18个月,14例获良好骨愈合,平均骨愈合时间为18周,有4例出现骨延迟愈合或骨不连,无骨髓炎发生。结论对枪伤致四肢长骨干严重粉碎性骨折,在彻底清创的基础上,一期整复骨折并内固定是可行的。半环式梯形加压钢板对该类骨折的固定具有独到的优点。

Objective To study the repair of the severe comminuted long bone fracture injured by gunshot,and evaluate its results.Methods 18 cases of severe comminuted long bone fracture injured by gunshot were treated with early debridement,1-stage fixation with semi-circular ladder plate.All the blood vessels injury and peripheral nerves injury were carried out 1-stage repairement primarily.Results All the wounds healed at one stage.All the cases were followed up for a period of 5-18 months,and 14 cases had a fine bone union.The mean time of bone union was 18 weeks.4 cases had a faulty bone union,and no bone infection occurred.Conclusion On the basis of thorough debridement,1-stage fixation can be used to treat the severe comminuted long bone fracture injured by gunshot.Semi-circular ladder plate has its unique advantages in the treatment of this kind of feature.