合并长骨骨折颅脑损伤的救治

Treatment of patients with head injuries accompanied by long-bone fractures

目的探讨合并长骨骨折颅脑损伤的救治特点。方法回顾性分析1995年1月至1998年12月4年间收治的中重型颅脑损伤合并长骨骨折119例资料。结果早期行骨折内固定手术组，死亡6例（占8．8％），62例骨折愈合良好（占91．2％），无骨折畸形愈合；非手术组，死亡13例（占25．5％），骨折愈合良好12例（占23.5％），骨折畸形或延迟愈合26例（占51％）。结论对颅脑损伤合并长骨骨折者应尽早行内固定，有利于颅脑损伤的治疗和护理，防止肺炎、ARDS、脂肪栓塞、褥疮等并发症，从而降低伤残率及死亡率。

objective To study the feasibility of early internal fixation in 119 patients with a moderate or severe head injuryassociated with long-bone fractures. Method A retrospective review was made on clinical data of 119 patients with concomitanttraumatic head injury and long-bone fractures treated from January 1995 through December 1998. Results In 68 petients.whounderwent early internal fixation (operation group), 62 (91.2%) had good fracture bony union, only 6 (8.8%) died, none hadmalunion. In 51 patients without operation (non operation group), only 12 (23.5%) had good bony union, but 26 (51%) had malunionand 13 (25.5%) died. Conclusion Internal fixation of fracture should be given as soon as possible in patients with a head injuryassociated with long-bone fractures, which benefits on therapy and nursing and can prevent some complications such aspostoperation pneumonia, fat embolism and adult respiratory distress syndrome to decrease mortality and disability