BACKGROUND Different external skeletal fixators have been widely used in preoperative traction of high-energy tibial fractures prior to a definitive surgical treatment.However,the early complications associated with t...BACKGROUND Different external skeletal fixators have been widely used in preoperative traction of high-energy tibial fractures prior to a definitive surgical treatment.However,the early complications associated with this staged treatment for traction and soft tissue injury recovery have rarely been discussed.AIM To analyze the early complications associated with preoperative external traction fixation in the staged treatment of tibial fractures.METHODS A total of 402 patients with high-energy tibial fractures treated using preoperative external traction fixation at a Level 1 trauma center from 2014 to 2018 were enrolled in this retrospective study.Data regarding the demographic information,Tscherne soft tissue injury,fracture site,entry point placement,and duration of traction were recorded.Procedure-related complications such as movement and sensation disorder,vessel injury,discharge,infection,loosening,and iatrogenic fractures were analyzed.RESULTS The mean patient age was 42.5(18-71)years,and the mean duration of traction was 7.5(0-26)d.In total,19(4.7%)patients presented with procedure-related complications,including technique-associated complications in 6 patients and nursing-associated complications in 13.Differences in the incidence of complications with respect to sex,affected side,soft tissue injury classification,and fracture sites were not observed.However,the number of complications due to hammer insertion was significantly reduced than those due to drill insertions(2.9%vs 7.4%).CONCLUSION We found a low incidence of early complications related to the fixation.Furthermore,the complications were not significantly associated with the severity of the soft tissue injury and fracture site.Although relatively rough and more likely to cause pain,the number of complications associated with hammer insertion was significantly smaller than that of complications associated with drill insertion.展开更多
目的:观察顺势双反牵引复位器复位髓内钉内固定治疗股骨干骨折的临床疗效及安全性。方法:回顾性分析2019年5月至2021年5月收治的30例股骨干骨折患者的病例资料,均采用髓内钉内固定治疗,其中15例采用顺势双反牵引复位器复位(复位器组)、1...目的:观察顺势双反牵引复位器复位髓内钉内固定治疗股骨干骨折的临床疗效及安全性。方法:回顾性分析2019年5月至2021年5月收治的30例股骨干骨折患者的病例资料,均采用髓内钉内固定治疗,其中15例采用顺势双反牵引复位器复位(复位器组)、15例采用牵引床复位(牵引床组)。比较2组患者的复位时间、术中X线透视次数、手术时间、术中出血量,以及术后2周膝部疼痛视觉模拟量表(visual analogue scale,VAS)评分、术后6个月美国特种外科医院(Hospital for Special Surgery,HSS)膝关节评分、术后并发症发生情况。结果:2组患者骨折均愈合。复位器组在复位时间、术中X线透视次数、手术时间、术中出血量、术后2周膝部疼痛VAS评分方面均优于牵引床组[(8.36±2.53)min,(20.27±5.38)min,t=12.390,P=0.000;(10.51±3.22)次,(18.64±2.73)次,t=7.459,P=0.000;(85.22±20.34)min,(110.56±21.25)min,t=3.336,P=0.002;(120.23±21.68)mL,(180.67±21.23)mL,t=7.714,P=0.000;(3.27±2.02)分,(5.20±1.97)分,t=-2.665,P=0.013];2组患者术后6个月HSS膝关节评分比较,组间差异无统计学意义[(88.22±6.34)分,(80.32±2.71)分,t=1.146,P=0.261]。术后复位器组出现下肢深静脉血栓1例、下肢力线不良1例,牵引床组出现下肢深静脉血栓1例、会阴部挤压伤3例、足踝部挤压伤1例、切口脂肪液化1例、腓总神经损伤2例、下肢力线不良2例、贫血1例,复位器组的并发症发生率低于牵引床组(P=0.003)。结论:顺势双反牵引复位器复位髓内钉内固定治疗股骨干骨折,与牵引床复位髓内钉内固定相比,两者在膝关节功能恢复方面无明显差异,但前者比后者的复位时间短、术中X线透视次数少、手术时间短、术中出血量少、术后膝部疼痛改善情况好,且并发症少。展开更多
文摘BACKGROUND Different external skeletal fixators have been widely used in preoperative traction of high-energy tibial fractures prior to a definitive surgical treatment.However,the early complications associated with this staged treatment for traction and soft tissue injury recovery have rarely been discussed.AIM To analyze the early complications associated with preoperative external traction fixation in the staged treatment of tibial fractures.METHODS A total of 402 patients with high-energy tibial fractures treated using preoperative external traction fixation at a Level 1 trauma center from 2014 to 2018 were enrolled in this retrospective study.Data regarding the demographic information,Tscherne soft tissue injury,fracture site,entry point placement,and duration of traction were recorded.Procedure-related complications such as movement and sensation disorder,vessel injury,discharge,infection,loosening,and iatrogenic fractures were analyzed.RESULTS The mean patient age was 42.5(18-71)years,and the mean duration of traction was 7.5(0-26)d.In total,19(4.7%)patients presented with procedure-related complications,including technique-associated complications in 6 patients and nursing-associated complications in 13.Differences in the incidence of complications with respect to sex,affected side,soft tissue injury classification,and fracture sites were not observed.However,the number of complications due to hammer insertion was significantly reduced than those due to drill insertions(2.9%vs 7.4%).CONCLUSION We found a low incidence of early complications related to the fixation.Furthermore,the complications were not significantly associated with the severity of the soft tissue injury and fracture site.Although relatively rough and more likely to cause pain,the number of complications associated with hammer insertion was significantly smaller than that of complications associated with drill insertion.
文摘目的:观察顺势双反牵引复位器复位髓内钉内固定治疗股骨干骨折的临床疗效及安全性。方法:回顾性分析2019年5月至2021年5月收治的30例股骨干骨折患者的病例资料,均采用髓内钉内固定治疗,其中15例采用顺势双反牵引复位器复位(复位器组)、15例采用牵引床复位(牵引床组)。比较2组患者的复位时间、术中X线透视次数、手术时间、术中出血量,以及术后2周膝部疼痛视觉模拟量表(visual analogue scale,VAS)评分、术后6个月美国特种外科医院(Hospital for Special Surgery,HSS)膝关节评分、术后并发症发生情况。结果:2组患者骨折均愈合。复位器组在复位时间、术中X线透视次数、手术时间、术中出血量、术后2周膝部疼痛VAS评分方面均优于牵引床组[(8.36±2.53)min,(20.27±5.38)min,t=12.390,P=0.000;(10.51±3.22)次,(18.64±2.73)次,t=7.459,P=0.000;(85.22±20.34)min,(110.56±21.25)min,t=3.336,P=0.002;(120.23±21.68)mL,(180.67±21.23)mL,t=7.714,P=0.000;(3.27±2.02)分,(5.20±1.97)分,t=-2.665,P=0.013];2组患者术后6个月HSS膝关节评分比较,组间差异无统计学意义[(88.22±6.34)分,(80.32±2.71)分,t=1.146,P=0.261]。术后复位器组出现下肢深静脉血栓1例、下肢力线不良1例,牵引床组出现下肢深静脉血栓1例、会阴部挤压伤3例、足踝部挤压伤1例、切口脂肪液化1例、腓总神经损伤2例、下肢力线不良2例、贫血1例,复位器组的并发症发生率低于牵引床组(P=0.003)。结论:顺势双反牵引复位器复位髓内钉内固定治疗股骨干骨折,与牵引床复位髓内钉内固定相比,两者在膝关节功能恢复方面无明显差异,但前者比后者的复位时间短、术中X线透视次数少、手术时间短、术中出血量少、术后膝部疼痛改善情况好,且并发症少。
