一期植骨外固定加灌洗修复下肢火器伤骨缺损

Primary repair of firearm bone injuries of low extremities by external fixation devices with bone graft and local irrigation

目的评价一期植骨外固定和灌洗修复下肢火器伤骨缺损的疗效。方法17例下肢火器伤长骨开放粉碎性骨折伴骨缺损,早期彻底清创,一期自体髂骨瓣植骨,外固定架固定,术后给予持续灌洗、抗生素治疗。结果16例术后随访7～24个月,6～8周有骨痂形成,植骨与宿主骨愈合时间平均8个月,无骨不愈合发生。结论外固定架在四肢长骨火器性损伤骨缺损治疗中具有独特的优越性,辅以自体髂骨植骨和术后持续灌洗可以一期修复伤口污染轻、软组织缺损少的火器性损伤。

Objective To evaluate the primary treatment results of firearm injuries of low extremities by external fixation devices with bone graft and local irrigation.Methods All the17cases were fresh firearm injuries of low extremities long bone with open comminuted fracture and bone defects.Early thorough cleaning wound,autogenous iliac bone grafting,using external fixation devices and local irrigation of antibiolic liquid were proformed in the primary reconstructive operation.Results The16of17cases were follow-uped for7-24months post-operatively.Callus were seen in6-8th weeks.Union of transplanted bone with the host bone occurred in8th months on the average.Non-union were not seen.Conclusion It is emphatically pointed out that the external fixation devices has its unique advantages in the treatment of firearm injuries of extremities long bone with bone defects,and adding autogenous iliac bone grafting plus continous postoperative irrigation,can primaryly repair firearm injnries with lighter contaminate wound and less defect of soft tissue.