四肢骨折术中骨折小碎片的处理经验

Treatment experience of small pieces in limb fracture surgery

目的探讨四肢骨折术中骨折小碎片处理的方法及意义。方法四肢粉碎性骨折患者713例,其中男性505例,女性208例;年龄2～96岁,平均年龄33岁。应用明胶海绵、可吸收线在手术中固定骨折小碎片进行治疗。结果 675例用此方法处理治疗的患者,术后配合积极的康复治疗,随访1～12个月,患者骨折小碎片复位好,至骨折愈合未发生移位,1年后骨折愈合;35例开放性骨折患者术后1年断端骨痂部分生长,延迟愈合,经继续康复治疗6个月至1年后骨折愈合;3例骨折断端无骨痂生长,骨折断端硬化,骨不连,再次手术后12~20个月后骨折愈合。结论利用明胶海绵、可吸收线固定处理骨折小碎片,取得良好的临床效果,具有处理简单、术后组织反应小、组织相容性好、不需再次手术取出内固定物、疗效肯定等优点。

Objective To investigate the treatment methods and significance of small pieces in limb fracture surgery.Methods A total of 713 patients with limb fractures were enrolled,male 505,female 208,aged 2-96 years old,mean age 33 years old,which were fixed fracture fragments with gelatin sponge and absorption thread.Results The 675 cases with the treatment method were performed active rehabilitation after operation and followed-up 1-12 months.The patients showed that small fractures fragments were reset and without displacement for fracture healing after 1-year.Thirty-five cases of open fractures patients showed end callus partial growth with healing delayed after 1-year,and fracture healing after rehabilitation for 6-month to 1-year;3 cases fracture broken end without callus growth,fracture fragments sclerosis and bone nonunion,fracture healed in the second surgery after 12-20 months.Conclusion It is demonstrated that fixation treatment of fractures in small fragments with gelatin sponge and absorbable thread could achieve good clinical results,which have the advantages of simple processing,little postoperative tissue reaction,good histocompatibility,without surgery for removal implantations and positive therapeutic effects.