下肢损伤薰洗方联合切开复位内固定治疗B2型踝关节骨折35例临床观察

Open Reduction and Internal Fixation of Combined Therapy with Chinese Medicine Embalm Wash B2 Type 35 Cases of Clinical Observation Ankle Fractures

[目的]观察下肢损伤薰洗方联合切开复位内固定治疗B2型踝关节骨折疗效。[方法]对35例住院患者切开复位内固定,骨折部位局部无水疱,患足肿胀较轻,可尽快安排手术;肿胀严重,入院后抬高患肢,脱水药物,肿胀减退后再手术。手术：全身麻醉或蛛网膜下腔阻滞麻醉,仰卧,常规消毒、铺无菌巾。踝关节前外侧入路,纵行切开皮肤和皮下组织,清理骨折断端碎骨块和软组织,暴露腓骨远端及外踝,复位后钢板固定。前内侧弧形切口显露并清理内踝骨折端,复位后以拉力螺钉固定。修复韧带,冲洗,缝合切口。术后石膏托固定,将患肢抬高,常规抗生素预防感染。药力消除后指导进行功能锻炼。薰洗：术后4周下肢损伤薰洗方（伸筋草、透骨草各15g,五加皮、三棱、莪术、秦艽、海桐皮各12g,牛膝、木瓜、红花、苏木各10g）,水煎500mL,倒入沸水盆中,患足置盆上薰蒸。药汁稍凉,毛巾蘸取药汁洗敷患处直至药液变凉。2次/d。连续治疗10d为1疗程。观测临床症状、踝关节骨折、踝关节功能、不良反应。治疗1疗程,随访3∽6个月,判定疗效。[结果]治愈29例,好转6例,无效0例,治愈率85.85%。[结论]下肢损伤薰洗方联合切开复位内固定治疗B2型踝关节骨折效果显著,值得推广。

[ Objective ] to observe the open reduction and internal fixation of combined therapy with Chinese medicine embalm wash type B2 ankle fracture curative effect. [ Methods ] to 35 cases of hospitalized patients：a fracture local no blister, plantar swelling is lighter, can be arranged as soon as possible surgery; Severe swelling and raise the limb after admission, to dehydration drugs, decreased swelling after the operation. Operation：general anesthesia or subarachnoid block anesthesia, lie on your back, regular disinfection, sterile towels. Anterolateral approach to the ankle, longitudinally, the skin and subcutaneous tissue, clearing of fracture end broken bones and soft tissue, and external ankle exposed fibular end, plate fixation after reset. Curved incision in the former and clean up the medial malleolus fracture end, to pull screws after reset. Repair ligament, flushing, small incisions. Postoperative plaster fixed, raise, limb to conventional antibiotics to prevent infection. After eliminating drug guidance function of exercise. Kaori wash ： 4 weeks after lower limb injury wash Fang Xun wash （ Shenjincao, Tougucao each 15 g, Wujiapi, Sanleng, E＇ zhu, Qinjiu, Haitongpi each 12g, Niuxi, Mugua, Honghua, Sumu every 10g）, Fried 500 ml water, pour into boiling water basin, basin fumigation on plantar. Medicine juice cool, dip in with towel take medicine juice washing apply affected part until cool solution. 2 times/d. Continuous treatment of 10 d to 1 course of treatment. Observation of clinical symptoms and adverse reactions. As a course treatment, judge curative effect. [ Results ] to cure 29 cases, 6 cases improved, 0 no effect, the cure rate was 85.85%. Cured. [ Conclusion ] open reduction and internal fixation with combined traditional Chinese medicine （ TCM ） type B2 ankle fractures treated by washing effect is remarkable, is worth promoting.