长管状骨骨折治疗进展

The recent progress of the treatment of the fractures of long tubular bones

长管状骨骨折非手术治疗和手术治疗的方法各有其特点,治疗方法的选择应根据损伤的程度和性质确定。非手术治疗对于儿童骨折、成人易于手法复位的骨折及手术后的辅助治疗是较理想的选择。对于伴有严重软组织损伤的长管状骨开放性骨折、全身多发伤合并长管状骨骨折的早期救治和火器伤等,应优先采用骨外固定架治疗,而对全身情况稳定的开放性骨折、多发性骨折、多段骨折、关节内骨折及合并血管神经损伤的骨折等,应采取积极的手术治疗,并选择尽量减少对软组织血运破坏的生物学固定方法。认为今后治疗的趋势是:精心的治疗设计、微创接骨技术、良好的骨折复位、稳妥的生物学固定、早期功能锻炼,以最大限度地恢复肢体的功能。

This article reviews the currently most widely used methods and their features of the non operative and operative treatment for the fractures of long tubular bones. It is widely accepted that each of the two methods is useful in its injury degree and in kind. It is wise to choose the non operative treatment for child fractures, adult fractures easily reduced, and the complementary therapy after surgery. External bone fixation is preferentially selected as for the open long tubular bone fracture with severe injuries to the soft tissues, early freatments of long tubular bone fracture with multiple injuries all over the body and fire arm injury. While it is widely accept that an active operative treatment should be take for the open fractures, multiple fractures, multi plane fractures, intraarticular fractures, and the fractures with vessel or nerve injury, and the biological fixation should be chosen in order not to impair circulartory supply of soft tissues. Arriving at the conclusions that future studies of the treatments for the fractures of long tubular bones will be conducted in meticulously design for therapy, minimally invasive osteosynthesis, satisfactory reduction, stably biological fixation, immediately active motion and results in a good runctional recovery for the limbs.