武警医学2012，Vol.23Issue(6)：483-485,3.
损伤控制骨科理念在Gustilo Ⅲ型胫腓骨骨折治疗中的应用
Application of damage control orthopaedics to treating Gustilo type Ⅲ tibial and fibulal fracture
蔺文祥 1王志强 2范熙明 1孙明华 2王彦鹏2
作者信息
- 1. 030600,晋中,武警8650部队医院骨科
- 2. 300162,天津,武警后勤学院附属医院骨科
- 折叠
摘要
Abstract
Objective To discuss and analyze the clinical effect of damage control orthopaedics (DCO) in 56 patients with Gustilo type III fractures of tibia and fibula. Methods A retrospective analysis was made of the 56 patients who were admitted from January 2006 to December 2010 for Gustilo type Ⅲ fractures of tibia and fibula. There were 19 cases of type Ⅲ A, 32 cases of typeⅢ B, and 5 cases of ⅢC. All the 56 cases were treated with anti - shock measures, followed by vacuum sealing drainage and external fixation of fractures thorough debridement in the first stage, resuscitation in the ICU in the second stage, and definite surgery if the parenchyma permitted in the third stage. Results All the 56 patients were followed up for 16. 8 months on average (12-27 months) . There were 3 cases (5.4% ) of delayed healing and 53 cases (94. 6% ) of bone healing by first intention. No osteomyelitis, bone nonunion or further complications were observed. The scoring system Johner - Wruhs assessment of efficacy for treatment was used. The results were excellent in 26 cases, good in 24 cases, and poor in 6 cases. The excellent and good rate was 89. 3% . Conclusions Application of DCO is effective for Gustilo type Ⅲ fractures of tibia and fibula with haemorrhagic shock and/or no craniocerebral injury, chest injury and abdomen injury. In the early treatment of such fracture, external fixation for fracture repair, thorough debridement and VSD covering wound surfaces should be emphasized.关键词
损伤控制骨科/胫腓骨骨折/骨折固定术,外/负压封闭引流技术Key words
damage control orthopaedics (DCO) / tibia and fibula fractures/ fracture fixation/ external/ vacuum sealing drainage (VSD)分类
医药卫生引用本文复制引用
蔺文祥,王志强,范熙明,孙明华,王彦鹏..损伤控制骨科理念在Gustilo Ⅲ型胫腓骨骨折治疗中的应用[J].武警医学,2012,23(6):483-485,3.
