几种开放性骨折治疗方法的比较分析

Several comparative analysis of open fracture treatment

目的 目前对开放性骨折的治疗方法较多,比较分析不同治疗方法是极其必要的.方法 本研究对2011年1月-2012年12月收住我院的82例胫骨开放性骨折患者的基本情况进行评价分析.结果 Ⅰ型的48例患者术后3～6个月内骨折已经愈合,且无感染发生.36例Ⅱ型患者,29例3～6个月骨折愈合,7例需要Ⅱ期植骨,3例患者发生感染.23例ⅢA型患者,17例患者4～7个月骨折完全愈合,6例需进行Ⅱ期植骨,2例发生感染.14例ⅢB型患者,11例患者4～9个月骨折愈合,3例患者进行Ⅱ期游离植骨,2例发生感染.5例ⅢC型损伤,3例Ⅰ期截肢,2例患者经多次植骨后6～9个月愈合,1例发生感染.结论 胫骨开放性骨折钢板和螺钉内固定法利于患者康复;外固定支架方法是治疗ⅢB、ⅢC型的开放性骨折的首选固定方法;非扩髓髓内钉法是治疗Ⅰ、Ⅱ型及ⅢA型胫骨开放性骨折的首选方法.

Objective Purpose： Currently there are many treatment methods of open fractures. It＇s extremely necessary to compare and analysis of different treatment methods. Methods A retrospective survey was performed in 82 patients with open fractures of the tibia that were operatively treated from January 2011 to December 2012. Results 48 cases of Type I fracture were healed 3-6 months after fracture and zero infection. Of 36 cases of Type II fractures that twenty nine were healed 3 - 6 months after fracture, seven needed secondary bone implantation and three had infection. Of 23 cases of type IIIA fractures that seventeen were healed 4-7 months after injury, six needed secondary bone implantation and two had infection. Of 14 cases of type Ⅲ B fractures, 11 were healed 4-9 months after injury three needed secondary bone implantation and two had infection. Of 5 cases of type Ⅲ C fracture three needed amputation ,two were healed through repeated bone healing after 6-9 months and one had infection. Conclusion Tibial fractures plates and screw fixation can benefit rehabilitation of patients. External fixation method is the first choice for the treatment of Ⅲ B, Ⅲ C-type fracture fixation. Non-reamed intramedullary nailing is the first choice for the treatment of type Ⅱ and Ⅲ A-type open tibial fractures.