Epidemiology of Open Limb Fractures in a Country with Low-Income

Introduction: Open limb fractures are frequent and severe. Very often they result from high velocity traffic accidents. The aim of this study was to identify the epidemiologic aspects of open limb fractures in order to improve prevention and care. Material and Methods: It was a retrospective study carried out in the Department of Orthopaedic and traumatology Surgery of Afagnan hospital. It concerned the files of patients admitted from January 1st to December 31st 2016. Patients of 15 years old and older who presented open limb fractures were included in the study. The study variables were: age, sex, occupation, trauma aetiology, injury mechanism, location and type of lesions. An X-ray (antero-posterior and lateral view) of the injured limb segment was done in all patients. Results: On 87 patients, 148 cases of fractures were collected. The mean age was 38.08 years with extremes of 15 and 82. There were 23 women (26.4%) and 64 men (73.6%). The most common etiology was traffic accidents (73.5%). Motorcycle accidents (58.3%);accidents involving motorcycle and car (19.4%). Accidents at work represented (16.1%). Lower limbs were more affected (77.1%). Open fractures classified Gustillo-Anderson type III were predominant with type IIIa (51.0%), IIIb (32.6%) and IIIc (16.3%). Conclusion: Open limb fractures are severe. They are mainly due to the increase of high-velocity traffic accidents. This explains the predominance of the young male population. Road safety and all actors’ behaviour change are essential for the reduction of traffic accident morbidity.

Open Fractures of Limbs by the Bite of Domestic Donkeys: An Unusual Aetiology

Introduction: The aim of this study is to describe the epidemiological, lesional, therapeutic and evolutionary profile of open fractures of limbs by bites of domestic donkeys. Patients and Methods: This is a prospective descriptive study over 28 months made in the Orthopedics-Traumatology department of the Tambacounda Regional Hospital in Senegal, concerning patients bitten by donkeys, resulting in an open fracture of the thoracic and pelvic limbs. Results: Twelve male patients were included. The average age was 10.50 years ± 2.60. The most common circumstance was the bite when two donkeys were separated. The thoracic limbs were the most affected by the occurrence of the arm. Cauchoix-Duparc type II and AO A2 and B2 were predominant. The essential trimming/osteosynthesis was carried out within 24 hours of the bite. Serovaccination was systematic, but on the other hand, a single dose of anti-rabies serum was administered. Pinning was the most commonly used bone synthesis. Complications were mainly infectious, followed by a case of radial nerve palsy and non-union on pins. Conclusion: The typical profile of an open donkey bite fracture is a male child/adolescent who is bitten during the separation of two fighting donkeys. The lesions are most often found in the thoracic limbs with a predominance of Cauchoix-Duparc type II and type A2 and B2 fractures of the AO, whose treatment consisted of trimming and pinning. The infectious complications of the soft tissues marked the evolution.

Epidemiological and Clinical Pattern of Open Fractures of Long Bones of the Lower Limbs in the South-West Region of Cameroon: A 5-Year Review

Background: An open fracture is an injury in which the fracture site and/or hematoma communicates with the external environment. It is associated with significant morbidity and disability and is a challenge to the surgical team. The lower extremities are the most often exposed to traumatic injuries compared to other anatomical parts of the body. Patterns of open fractures differ with different mechanisms of injury and the segment of the long bone affected. The correct and timely management of open fractures is beneficial to the patients and leads to a more favorable outcome. This study aimed at describing the pattern of open fractures of long bones of the lower limb treated in 3 major hospitals of the south west region, Cameroon. Methodology: This was a hospital-based retrospective review of files of patients with open fractures of long bones of the lower limb managed at the surgical units of three secondary health facilities in the South-West region of Cameroon from the 1st of January 2015 to the 31st of December 2019. The socio-demographic characteristics, clinical presentation, treatment modalities, and outcomes were recorded. The data was stored and analyzed using Epi info version 7.0 and SPSS version 23.0 respectively. Results: A total of 195 files of patients aged 8 to 80 years were studied. The main age group affected was between 20 - 40 years. There were 147 (75.4%) males and 48 (24.6%) females giving a sex-ratio of 3.1:1. The most common cause was road traffic crashes 142 (72.8%). In 98 cases (50.3%), the left side was more involved. The tibia was the most common long bone affected in 75 (38.5%) cases. Comminuted fracture was the most common fracture pattern encountered in 126 cases (64.6%). A total of 76 (39%) fractures were graded Gustilo-Anderson IIIA. External fixator was used in 112 cases (57.1%) and internal fixator in 86 cases (42.9%). We recorded 127 (65.1%) cases of wound infection and 143 (73.3%) cases of limb shortening as the most common complications. Other complications include: 20 cases (17.1%) of mal-union, 27 cases (22.5%) of delayed union, 18 cases (15.1%) of non-union and 50 cases (38.5%) chronic osteomyelitis. We recorded a mortality of 2.1%. Gustilo IIIB and IIIC were associated to chronic osteomyelitis (P = 0.02). Conclusion: Open fractures of long bones of the lower limb affect the active age group of the population and road traffic crashes are the most common causes. It tends to affect the left side and the tibia being the most fractured long bone. A reasonable proportion of these fractures subsequently get infected. Comminuted fracture is the common fracture pattern.

Outcome of application of primary versus secondary Illizarov＇s fixator in open tibial shaft fractures

BACKGROUND: The present study aimed to compare outcome of primary and secondary Illizarov's fi xator application as a treatment method for type III open tibial fractures in terms of nonunion and wound infection.METHODS: This prospective study was done in a tertiary care center. Forty-eight type III tibial fractures were treated with Illizarov's apparatus between 2008 and 2011. The patients were divided into two groups depending on the treatment protocol, timing of wound closure and Illizarov's application, primary(n=28) and secondary(n=20).RESULTS: In the primary group, healing was achieved in all 28 patients. The median time to recovery was 24 weeks, and the median number of operations was 3. There were 6 patients with a bone defect. In the secondary group, complete recovery was achieved in 18 out of 20 patients. The median time to recovery was 30 weeks, and the median number of operations 5. There were 9 patients with a bone defect. The median time to recovery and the number of operations were signifi cantly smaller in patients undergoing primary operation. Union was 100% in the primary group and more than 95% in the secondary group. Chronic osteomyelitis persisted in one patient and below amputation was done in one patient in the secondary group.CONCLUSION: Primary wound closure and Illizarov's fixation required a smaller number of operations and shorter time to recovery than secondary wound closure and Illizarov's fi xation, mostly due to a signifi cantly less number of patients with a bone defect in the primary group.

Postoperative Fracture Healing Effects of Locking Compression Plate for the Treatment of Limb Fractures

Objectives To study the effects of applying locking compression plates in the treatment of patients with limb fractures on postoperative fracture healing.Methods:115 patients with limb fractures who were treated in our hospital from November 2019 to November 2020 were selected.In order to study the effective treatment method,the random-number table method was used in this study to divide the patients into two groups,namely the experimental group and the control group,and the locking compression plate treatment method and the pure plate and screw internal fixation treatment method were administered respectively to study their clinical application effects.Results:Compared with the control group,patients in the experimental group had a lower incidence of complications,shorter hospitalizations and shorter recovery time.Meanwhile,the experimental group had a better quality of recovery,and all data were significantly different from those of the control group,P<0.05,the intervention effect of the experimental group was better.Conclusion:The application of the locking compression plate in the treatment of patients with limb fractures is more conducive to promoting the postoperative healing of the patients'fractures,reducing the incidence of postoperative complications,and promoting the rapid recovery of patients,which has positive significance for clinical development.

Internal fixation and unicompartmental knee arthroplasty for an elderly patient with patellar fracture and anteromedial osteoarthritis:A case report

BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patients with medial knee osteoarthritis(OA).However,the process of choosing treatment for patients with both patellar fractures and anteromedial knee OA remains unclear.We present the case of a patient with a patellar fracture and anteromedial OA.CASE SUMMARY We present the case of a 72-year-old woman with a history of bilateral medial compartment OA of the knees and a right Oxford UKA.She also experienced a recent left patellar fracture.ORIF and Oxford UKA were performed in a single stage.The patient showed excellent postoperative clinical results.CONCLUSION ORIF and Oxford UKA can be performed simultaneously for patients with patellar fracture and anteromedial OA on the same knee.

四肢创伤开放性并粉碎性骨折患者发生谵妄的列线图预测模型构建

目的分析四肢创伤开放性并粉碎性骨折患者发生谵妄的危险因素,构建并验证风险预测模型。方法回顾性分析2021年3月至2023年3月西安高新医院收治的108例四肢创伤开放性并粉碎性骨折患者的病历资料,其中男76例、女32例,年龄(54.17±14.62)岁。依据80/20定律随机分为训练集(86例)和验证集(22例)。统计患者术后1个月内谵妄的发病情况,根据患者术后是否发生谵妄分为谵妄组与非谵妄组,筛查四肢创伤开放性并粉碎性骨折患者术后发生谵妄的危险因素,构建并验证风险预测模型。采用t检验、χ^(2)检验、logistic回归模型、受试者操作特征曲线(ROC)、Hosmer-Lemeshow检验。结果86例四肢创伤开放性并粉碎性骨折患者中18例患者术后发生谵妄,发生率为20.93%(18/86)。谵妄组患者的年龄、脑卒中史占比、术中低氧血症占比、血清可溶性肿瘤坏死因子1(sTNFR1)水平均高于非谵妄组(均P<0.05)。年龄(OR=3.187,95%CI 1.176~8.633)、脑卒中史(OR=3.684,95%CI 1.359~9.979)、术中低氧血症(OR=4.958,95%CI 1.830~13.431)、血清sTNFR1(OR=4.591,95%CI 1.695~12.435)均是四肢创伤开放性并粉碎性骨折患者术后发生谵妄的危险因素(均P<0.05)。风险预测模型预测训练集86例四肢创伤开放性并粉碎性骨折患者术后发生谵妄的灵敏度为0.825(95%CI 0.741~0.922),特异度为0.829(95%CI 0.753~0.906),曲线下面积为0.892(95%CI 0.808~0.915)。风险预测模型预测验证集22例四肢创伤开放性并粉碎性骨折患者术后发生谵妄的灵敏度为0.799(95%CI 0.706~0.881),特异度为0.732(95%CI 0.658~0.827),曲线下面积为0.839(95%CI 0.791~0.915)。结论年龄、脑卒中史、术中低氧血症、血清sTNFR1均与四肢创伤开放性并粉碎性骨折患者术后发生谵妄有关,构建风险预测模型有助于早期预测术后谵妄的发生风险。

骨短缩-延长肢体治疗下肢开放性粉碎性骨折临床疗效分析

目的 探讨使用Orthofix单边外固定架通过骨短缩-延长肢体治疗下肢开放性粉碎性骨折临床疗效。方法 回顾性分析2017年1月~2022年3月深圳市龙华区中心医院创伤骨科使用Orthofix单边外固定架通过骨短缩-延长肢体治疗下肢开放性粉碎性骨折患者25例,男性18例,女7例,年龄20~57岁,平均38.6岁,股骨8例,胫骨17例,左侧14例,右侧11例,GustiloⅢC型5例,GustiloⅢB型20例,交通事故17例,重物砸伤8例,2例合并2型糖尿病,合并软组织缺损23例,合并大动静脉缺损3例(缺损长度分别为9 cm, 5 cm, 4 cm),合并踝关节骨折5例。所有病例经清创后出现骨缺损,骨缺损长度5~23 cm,平均缺损长度10 cm,软组织缺损面积8 cm×5 cm~18 cm×10 cm。GustiloⅢC型患者根据缺损动静脉长度进行相应长度骨短缩并用组合式外固定架固定,直接闭合创面或封闭负压引流。GustiloⅢB型患者一期骨短缩3~7 cm并用组合式外固定支架固定,创面直接闭合或封闭负压引流,合并大动静脉缺损患者1.5月后安装Orthofix单边外固定架,并行股骨或胫骨截骨延长术,未合并大动静脉缺损患者术后1周左右复查白细胞计数、中性粒细胞计数、C反应蛋白及降钙素原正常后,安装Orthofix单边外固定架+股骨或胫骨截骨延长术。结果 随访12~36个月,所有患者骨及软组织缺损均愈合,未出现下肢不等长>2.5 cm、骨延长区域或骨折端再发骨折等并发症。骨性愈合时间为12~24个月,平均18.6个月;骨性愈合指数为31.7~120.2 d/cm,平均63.8 d/cm;外固定时间为12~30个月,平均20.6个月;外固定指数为32.3~117.2 d/cm,平均56.8 d/cm。Ilizarov技术研究与应用学会(Association for Study and Application of Method of Ilizarov, ASAMI)骨愈合评价:优23例,良2例;ASAMI下肢功能评价:优17例,良7例,可1例。结论 使用Orthofix单边外固定架通过骨短缩-延长肢体治疗下肢开放性粉碎性骨折可同时修复骨与软组织缺损,无须移植血管神经及皮瓣修复,降低手术难度,值得临床推广。

四肢开放性粉碎性骨折的临床特点和手术治疗价值分析

目的分析四肢创伤开放性粉碎性骨折的特点以及手术治疗的效果。方法便利选取江阴市第四人民医院2021年11月—2023年11月收治的75例四肢开放性粉碎性骨折患者作为研究对象,以治疗方式的不同分为A组(30例)、B组(25例)、C组(20例)。A组行交锁髓内钉手术,B组行钢板内固定,C组行支架外固定,对比3组患者关节活动优良率、骨折愈合率、并发症总发生率、肢体功能评分。结果A组关节活动度优良率、骨折愈合率高于B组和C组,并发症总发生率低于B组和C组,差异有统计学意义(P均<0.05)。B组和C组骨折愈合率、并发症总发生率比较,差异无统计学意义(P均>0.05)。术前,3组患者肢体功能评分比较,差异无统计学意义(P>0.05)。术后,A组肢体功能评分高于B组和C组,差异有统计学意义(P均<0.05)。结论交锁髓内钉不管在关节活动度还是骨折愈合质量方面均优于其他术式,能大幅提升四肢功能,与四肢开放性粉碎性骨折治疗需求匹配。

超声引导下股神经联合坐骨神经阻滞麻醉对老年下肢骨折患者麻醉安全性及血浆皮质醇影响的研究

目的探讨对开展手术治疗的老年下肢骨折患者采用超声引导下股神经联合坐骨神经阻滞麻醉对麻醉安全性及血浆皮质醇的影响。方法通过随机数字表法将我院于2020年10月至2022年11月收治的老年下肢骨折患者88例分为两组(n=44)。两组均开展下肢骨折手术治疗,对照组和观察组分别采用腰硬联合麻醉和超声引导下股神经联合坐骨神经阻滞麻醉。比较两组相关临床指标、T0、T1、T2的MAP和HR、术后2 h、6 h、12 h、24 h疼痛(VAS评分)以及围术期血浆皮质醇水平。结果与对照组相比较,观察组感觉、运动神经阻滞起效、术后恢复排尿、下肢运动恢复时间均较短(P<0.05);与T 0时相比较,两组T 1、T 2时MAP水平下降,HR水平提升,且与对照组相比较,观察组MAP水平较低,HR水平较高(P<0.05);与对照组相比较,观察组术后2 h、6 h、12 h、24 h VAS评分均较低(P<0.05);术后2 h、术后第3天两组血浆皮质醇水平相较于麻醉前均有所提高,但与对照组相比较,观察组血浆皮质醇水平提升幅度较小(P<0.05)。结论对进行手术的老年下肢骨折患者采用超声引导下股神经联合坐骨神经阻滞麻醉,能起到良好的麻醉效果的同时对患者血流动力学水平的影响较小,具有较高的安全性,同时在稳定患者围术期血浆皮质醇水平,降低患者术后疼痛方面具有积极意义。

个性化护理配合心理疏导对老年下肢骨折患者运动功能及睡眠的影响

目的:探析老年下肢骨折患者术中个性化护理配合术前系统性心理疏导对下肢运动功能及睡眠质量的影响。方法:选取2022年10月至2023年10月福建中医药大学附属人民医院手术治疗的老年下肢骨折患者78例作为研究对象,按照随机数字表法分为对照组和观察组,每组39例。对照组应用常规护理,观察组应用术中个性化护理配合术前系统性心理疏导。对比2组患者睡眠质量、下肢运动功能以及疼痛评分情况。结果:护理后观察组患者睡眠深度、入睡时间、觉醒次数、觉醒时间比例、整体睡眠质量评分均高于对照组(均P<0.05)。护理后,2组患者下肢运动功能均高于干预前(均P<0.05),且观察组的下肢运动功能高于对照组(P<0.05)。护理后2组患者疼痛评分均降低(均P<0.05),且观察组的疼痛评分低于对照组(P<0.05)。结论:应用个性化护理配合心理疏导可以减轻老年下肢骨折患者疼痛感,提高睡眠质量,促进下肢运动功能康复。

艾司氯胺酮联合罗哌卡因舒芬太尼对下肢骨折手术患者术后硬膜外自控镇痛应用研究

目的:分析艾司氯胺酮联合罗哌卡因舒芬太尼对下肢骨折手术患者术后硬膜外自控镇痛的临床效果。方法:选取2022年3月至2023年2月于赣县区人民医院行下肢骨折手术患者60例作为研究对象,根据随机数字法分为两组。术后行连续硬膜外自控镇痛(Patient Controlled Epidural Analgesia,PCEA),对照组(30例)给予0.15%罗哌卡因+1μg/mL舒芬太尼+生理盐水(NS)总量至100mL,观察组(30例)给予0.15%罗哌卡因+0.5μg/mL舒芬太尼+0.5mg/mL艾司氯胺酮+NS总量至100mL。对两组术后不同时间点疼痛程度、运动阻滞情况、镇静评分、自控镇痛次数及不良反应进行比较。结果:术后6h、12h、24h及48h,观察组VAS评分均低于对照组;术后48h内自控镇痛次数少于对照组;术后6h,观察组Bromage评分高于对照组,有统计学差异(P<0.05)。术后12h、24h及48h,两组Bromage评分比较,无统计学差异(P>0.05);术后6h、12h、24h及48h,两组Ramsay镇静评分比较,无统计学差异(P>0.05)。且相较于对照组,观察组不良反应发生率较低,有统计学差异(P<0.05)。结论:对于下肢骨折手术的患者,0.15%罗哌卡因+0.5μg/mL舒芬太尼+0.5mg/mL艾司氯胺酮+NS总量至100mL效果确切,可有助于减轻患者疼痛,且较为安全。

辅助应用右美托咪定对老年下肢骨折全身麻醉患者苏醒期躁动及机体应激反应的影响

目的探讨辅助应用右美托咪定对老年下肢骨折全身麻醉患者苏醒期躁动及机体应激反应的影响。方法选取2021年6—12月广州市中西医结合医院收治的50例老年下肢骨折全身麻醉患者作为研究对象,依据麻醉药物的不同分为A组与B组,每组25例。A组麻醉诱导前给予右美托咪定,B组麻醉诱导前给予氯化钠溶液,比较两组自主呼吸恢复时间、睁眼时间、苏醒期躁动反应、机体应激反应及并发症发生情况。结果两组自主呼吸恢复时间、睁眼时间比较差异无统计学意义。A组拔管时、拔管后5 min苏醒期躁动反应Riker镇静与躁动(RSAS)评分均低于B组,差异有统计学意义(P<0.05)。术前、用药后30min,两组去甲肾上腺素(NE)、肾上腺素(E)及皮质醇(Cor)水平比较差异无统计学意义;用药后60min、术毕,A组NE、E、Cor水平均低于B组,差异均有统计学意义(P<0.05)。A组寒战发生率低于B组,差异有统计学意义(P<0.05);两组低氧血症、导管脱出发生率比较差异无统计学意义。结论右美托咪定能有效改善老年下肢骨折全身麻醉患者苏醒期躁动及机体应激反应,减少并发症发生。

老年下肢骨折患者术后不同阶段的跌倒恐惧状况及其影响因素调查

目的 探究老年下肢骨折患者术后不同阶段的跌倒恐惧水平及其影响因素。方法选择医院2021年1月—2023年1月收治的102例老年下肢骨折患者为调查对象,采用一般资料调查表、国际跌倒效能感量表(FES-I)、康复锻炼自我效能量表、医院综合焦虑抑郁量表、社会支持评定量表进行各阶段跌倒恐惧、康复锻炼自我效能、焦虑抑郁、社会支持水平的现状调查,通过单因素分析及多重线性回归模型分析各阶段跌倒恐惧水平的影响因素。结果 术后首次下床活动后跌倒恐惧水平为34.19±6.72分,术后1个月跌倒恐惧水平为31.63±6.48分,术后3个月跌倒恐惧水平为28.88±5.75分,患者术后不同阶段FES-I总分及各维度评分均呈逐渐下降趋势,且各阶段总分和各维度得分差异均具有统计学意义(P<0.05)。经过单因素分析筛选,多重线性回归分析显示,年龄、首次下床活动时间、术后疼痛评分、康复锻炼自我效能总分、焦虑抑郁总分是患者首次下床活动后跌倒恐惧的影响因素(P<0.05);年龄、术后疼痛评分、康复锻炼自我效能总分、焦虑抑郁总分、社会支持总分是术后1个月患者跌倒恐惧的影响因素(P<0.05);年龄、主要照护者、近半年跌倒次数、康复锻炼自我效能总分、焦虑抑郁总分、社会支持总分是术后3个月患者跌倒恐惧的影响因素(P<0.05)。结论 老年下肢骨折患者术后不同阶段跌倒恐惧是持续存在且动态变化的,老年下肢骨折患者术后各阶段跌倒恐惧水平呈下降趋势,各阶段跌倒恐惧的影响因素众多,且与康复锻炼自我效能、社会支持及焦虑抑郁情况呈密切相关性,提示临床人员应充分重视患者术后跌倒恐惧的评估,根据患者各阶段跌倒恐惧水平和相关因素提供针对性护理指导,以降低患者跌倒恐惧水平,提高康复依从性。

负压创口治疗与传统敷料治疗下肢创伤开放性骨折的比较

目的比较负压创口治疗(NPWT)与传统敷料治疗下肢创伤开放性骨折的疗效。方法回顾性分析2021年1月-2023年9月南阳文和骨科医院收治的下肢创伤开放性骨折患者120例,采用随机数表法随机分为对照组(传统敷料治疗,60例)和NPWT组(NPWT,60例),比较两组治疗效果、创口严重程度、疼痛、炎性反应。结果NPWT组创口体积缩小率、创口愈合率高于对照组(P<0.05)、创面感染率、创口愈合时间低于对照组(P<0.05);两组治疗1 d、7 d后压疮愈合(PUSH)评分、视角模拟评分(VAS)、高敏C反应蛋白(hs-CRP)、WBC水平低于治疗前(P<0.05),研究组PUSH评分、VAS评分、hs-CRP、WBC低于对照组(P<0.05);结论与传统敷料治疗下肢创伤开放性骨折比较,NPWT可降低创面的感染率,促进创口缩小和愈合,减轻创口严重程度和疼痛,降低炎性反应。

人性化急救服务在四肢骨干开放性骨折患者中的应用效果研究

目的:分析人性化急救服务在四肢骨干开放性骨折患者中的应用效果.方法:选取我院2020年2月-2021年2月收治的58例四肢骨干开放性骨折患者为研究对象,采用随机数字表法将其分为研究组与对照组,各29例.研究组实施人性化急救服务,对照组实施常规急救服务.比较2组救治效果、并发症发生情况及总满意度.结果:研究组骨折愈合率高于对照组,差异有统计学意义(P<0.05).2组骨折部位畸形、肢体运动功能障碍发生率比较,组间差异无统计学意义(P>0.05).研究组并发症总发生率为3.45%,低于对照组的34.48%,差异有统计学意义(P<0.05).研究组满意度为96.55%,高于对照组的75.86%,差异有统计学意义(P<0.05).结论:将人性化急救服务用于四肢骨干开放性骨折患者中,不仅可以获得相对理想的救治效果,也可降低并发症发生率,提高满意度,是一种较为理想的急救服务方法.

多维度护理对下肢开放性骨折患者术后负性情绪及护理满意度的影响

目的探究多维度护理对下肢开放性骨折患者术后负性情绪及护理满意度的影响。方法随机选取2023年1—12月内蒙古赤峰市医院骨二科收治的80例行下肢开放骨折手术患者为研究对象,根据不同的护理方法分为对照组和观察组,各40例。对照组予以传统护理,观察组在传统护理基础上予以多维度护理。比较两组负性情绪、护理满意度及并发症发生情况。结果对照组焦虑评分量表中的状态焦虑评分及特质焦虑评分均高于观察组,差异有统计学意义(P均<0.05)。观察组护理满意度为100%(40/40),高于对照组的90.00%(36/40),差异有统计学意义(χ^(2)=4.211,P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论下肢开放性骨折患者术后恢复进程较慢,采取多维度护理有助于降低患者负性情绪,提高其满意度,且减少并发症的发生。

复合负压吸引的外固定钢板治疗四肢开放性骨折患者的效果及对炎症指标、肢体功能的影响

目的分析复合负压吸引的外固定钢板治疗四肢开放性骨折患者的效果。方法选取2020年6月至2021年12月收治的82例四肢开放性骨折患者作为研究对象,按随机数字表法将其分为对照组和观察组,各41例。对照组采用外固定结合负压封闭引流(VSD)治疗,观察组采用复合负压吸引的外固定钢板治疗。比较两组的治疗效果。结果观察组的创口甲级愈合率、骨折愈合优良率高于对照组(P<0.05)。观察组的换药次数、创口愈合时间、骨折愈合时间、住院时间及术后7 d的视觉模拟量表(VAS)评分均优于对照组(P<0.05)。术后7 d,两组的降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及基质细胞衍生因子-1(SDF-1)水平均降低,且观察组低于对照组(P<0.05)。术后3个月,两组的简易Fugl-Meyer运动功能评价量表(FMA)及四肢活动评分均高于术后1个月(P<0.05);术后3个月,两组的FMA及四肢活动评分无显著差异(P>0.05)。结论复合负压吸引的外固定钢板治疗四肢开放性骨折能促进创面和骨折愈合,加快康复进程,减轻炎症反应,且有利于肢体功能恢复。

基于赏识教育的功能锻炼路径在胫腓骨骨折切开复位内固定术后患者中的应用效果

目的:观察基于赏识教育的功能锻炼路径在胫腓骨骨折切开复位内固定术后患者中的应用效果。方法:选取2020年12月至2023年4月于该院行胫腓骨骨折切开复位内固定术的80例患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各40例。对照组实施常规护理,观察组在对照组基础上实施基于赏识教育的功能锻炼路径护理,比较两组肢体功能优良率,依从性,护理前后疼痛程度[视觉模拟评分法(VAS)]评分、生命质量[世界卫生组织生存质量测定量表简表(WHOQOL-BREF)]评分及并发症发生率。结果:观察组肢体功能优良率为97.50%,高于对照组的80.00%,差异有统计学意义(P<0.05);观察组依从率为97.50%,高于对照组的77.50%,差异有统计学意义(P<0.05);护理14、30 d后,两组VAS评分均低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为2.50%,低于对照组的20.00%,差异有统计学意义(P<0.05);两组生理健康、心理健康、社会关系及环境等各项WHOQOL-BREF评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:基于赏识教育的功能锻炼路径应用于胫腓骨骨折切开复位内固定术后患者,可提高其护理依从性和生命质量,促进肢体功能恢复,减轻术后疼痛,降低术后并发症发生率,效果优于常规护理。

FLS模式康复护理对老年股骨粗隆间骨折切开复位内固定术后患者生活质量的影响分析

目的分析FLS模式康复护理在老年股骨粗隆间骨折切开复位内固定术后的应用效果。方法采用随机数字表法将2022年7月至2023年7月期间在我院接受老年股骨粗隆间骨折切开复位内固定术治疗的131例患者分为两组,对照组(65例)接受常规护理,观察组(66例)接受FLS模式康复护理,对比两组功能评定优良率、护理满意度和遵医行为、生活质量。结果观察组功能评定优良率高于对照组(P<0.05),遵医行为评分在用药、饮食、功能锻炼、并发症预防及遵医行为总分方面均高于对照组(P<0.05),生活质量评分在躯体功能、心理功能、物质生活及社会功能方面均高于对照组(P<0.05),护理满意度均高于对照组(P<0.05)。结论老年股骨粗隆间骨折切开复位内固定术后应用FLS模式康复护理,有助于提升患者遵医行为,可以促进患者肢体功能尽快恢复,改善患者生活质量,患者对护理也更加满意度。