分型治疗在胫骨下段开放性骨折1期手术中的应用

Application of Classification in the First Stage of Open Fracture of Lower Tibia

目的:探讨根据Gustilo分型选择Ⅰ期治疗胫骨下段开放性骨折的方案及疗效,減少并发症.方法:选取本院2017年1月-2019年1月收治的胫骨下段开放性骨折(伤后6-8小时)患者20例.所有患者均Ⅰ期行骨折固定(内固定或外支架固定),及Ⅰ期闭合创面.现回顾性分析其临床资料,对治疗经过及要点进行总结.结果:2例患者出现骨感染需进一步手术,5例患者出现皮肤坏死缺损需进一步皮瓣手术治疗,13例患者伤口Ⅰ期愈合.所有患者均获随访,时间12-18个月,平均(13.3±3.6)个月,骨折均愈合,1例患者出现跟腱挛缩,余病例下肢功能恢复满意.结论:胫骨下段开放性骨折,多伴有软组织缺损,Ⅰ期手术方案应根据分型进行相应的调整,方可获得满意的效果.

Objective:To study the choose according to Gustilo parting Ⅰ phase of the treatment of open fractures of tibia and curative effect to reduce complications.Methods:20 patients with open fractures of the lower tibia(6-8 hours after injury)admitted to our hospital from January 2017 to January 2019 were selected.All patients were Ⅰ line fracture fixation(internal fixation or external bracket),and Ⅰ closed a surface.Now the clinical data are retrospectively analyzed to summarize the treatment process and main points.Results:2 cases of patients with bone infection need further surgery,5 patients appear to be further flap surgery,skin necrosis defect Ⅰ 13 patients with wound healing.All patients were followed up for 12 to 18 months(13.3±3.6 months on average),and all fractures could be healed.One patient developed Achilles tendon contracture,while the rest had satisfactory recovery of lower limb function.Conclusion:lower segment tibia open fractures,accompanied by soft tissue defects,Ⅰ period operation scheme should be according to the classification of the corresponding adjustment,can obtain satisfactory results.