股骨干骨折带锁髓内钉术后感染的原因分析及处理

Causes analysis and handling of postoperative infection after femoral shaft fracture treated interlocking intramedullary nail

目的 探讨股骨干骨折带锁髓内钉固定术后感染的原因及处理方法。方法 对 8例术后感染病例进行回顾性分析。结果 2例抗生素治疗 ,6例应用闭式滴注引流、取出髓内钉、外固定架固定及抗生素等治疗。全部病例均获随访 ,随访时间 6 - 2 4个月 ,感染控制 ,骨折愈合。结论 感染后不要急于取出内固定 ,采用闭式滴注引流加抗生素治疗可获得满意效果。彻底清创与严格的无菌操作是减少股骨干骨折带锁髓内钉术后感染的有效措施。

Objective To investigate the causes and handling methods of postoperative infection of femoral shaft fracture treated with interlocking intramedullary nail.Methods 8 cases were analyzed retrospectively.Results 2 cases were treated by using antibiotics; The others were treated by using closed drainage, removing the locking nail, applying external fixation plus antibiotics .The follow-up period extended from 6-24 months and all 8 cases were observed till the infection were healed and fractures united.Conclusion The interlocking nail need not be removed immediately .The post-operative infection following interlocking nail fixation in fractures of femoral preferred to use closed drainage with additional antibiotics treatment.The effective measures to reduce the complications include strict master of the operative indications ,complete debridement and strict abacterial procedures. [