中国骨伤2025，Vol.38Issue(1)：41-46,6.DOI:10.12200/j.issn.1003-0034.20230382
显微外科技术对Gustilo ⅢC型胫腓骨开放性骨折患者的疗效与安全性研究
Efficacy and safety of microsurgery in patients with Gustilo ⅢC open fractures
摘要
Abstract
Objective To analyze the clinical efficacy and safety of microsurgery in patients with Gustilo 111 C open frac-tures.Methods A total of 64 patients with Gustilo Ⅲ C open fractures who were admitted to the hospital bewteen September 2018 and March 2022 were included,and divided into the observation group and the control group,with 32 cases in each one.In the observation group,there were 24 males and 8 females,aged from 29 to 42 years with an average of(36.59±3.24)years.The tibial defect ranged from 2 to 5 cm with an average of(3.41±0.61)cm,and the soft tissue defect area ranged from 34 to 76 cm2 with an average of(58.50±9.44)cm2.This group received microsurgical treatment.In the control group,there were 25 males and 7 females,aged from 27 to 44 years with an average of(37.59±3.21)years.The tibial defect ranged from 2 to 6 cm with an average of(3.59±0.80)cm,and the soft tissue defect area ranged from 36 to 78 cm2 with an average of(59.09±9.53)cm2.This group received conventional staged surgery,with plaster or brace fixation after initial debridement and appropriate internal fixation at a later stage.The Anderson scores,motor ability Fugl-Meyer scale,perioperative indicators,rehabilitation outcomes,and complications were compared between the two groups.Results The patients were followed up for a duration from 2.5 to 5.5 months with an average of(3.15±1.11)months.In the observation group,19 patients were rated as excellent,12 pa-tients as good,1 patient as fair,and no patients as poor.In the control group,11 patients were rated as excellent,13 patients as good,6 patients as fair,and 2 patients as poor.The difference in outcomes between the two groups was statistically significant(P＜0.05).The operation time,the hospitalization time,and the hospitalization cost in the observation group(4.39±0.69)h,(30.22±4.58)d,and(23,500±3,300)yuan,respectively were significantly lower than those in the control group(5.01±0.75)h,(33.28±3.74)d,and(30,200±5,200)yuan,respectively(P＜0.05).Revascularization time(134.25±14.76)h,wound healing time(11.34±1.56)d,and fracture healing time(3.09±0.42)months in the observation group were significantly shorter than those in the control group(P＜0.05)which were(189.36±22.17)h,(13.22±2.03)d and(4.02±0.57)months respectively.The motor ability(42.91±5.51)points,sensory function(46.19±3.53)points,and total Fugl-Meyer score(89.09±6.08)in the observation group were significantly higher than those in the control group(P＜0.05)which were(35.19±4.27),(34.03±3.79),(69.22±6.32)points respectivdy.In the observation group,there were 1 case of refractory wound and 3 cases of complete nerve injury,which were lower than those in the control group(8 cases and 10 cases,respectively,P＜0.05).The number of complications in the ob-servation group was lower than that in the control group(P＜0.05).Conclusion Microsurgical technique can effectively shorten the wound and fracture healing time in patients with Gustilo Ⅲ C open fracture,improve limb movement ability,and reduce the risk of poor prognosis and complications.关键词
Gustilo ⅢC型开放性骨折/显微外科技术/肢体功能Key words
Gutilo ⅢC open fracture/Microsurgical techniques/Limb function分类
医药卫生引用本文复制引用
王炳,朱诚,王平,吴子征..显微外科技术对Gustilo ⅢC型胫腓骨开放性骨折患者的疗效与安全性研究[J].中国骨伤,2025,38(1):41-46,6.基金项目
上海宝山区医学重点学(专)科及特色品牌建设项目(编号:BSZK-2023-Z04)Shanghai Baoshan District Medical Key Science(Specialty)and Characteristic Brand Construction Project(No.BSZK-2023-Z04) （专）
