四肢骨折伴主要血管损伤的临床治疗

目的探讨四肢骨折伴主要血管损伤急诊处理的临床效果。方法分别采用带锁髓内针、钢板螺钉和外固定支架固定骨折,根据血管损伤情况选择血管直接修补术、血管端端吻合术和血管移植术等方法治疗四肢骨折伴主要血管损伤45例。结果本组45例,肢体全部成活,伤口愈合好。随访6个月～3年。有6例骨不连,其余骨折愈合好;有7例因神经损伤恢复不理想,肢体感觉和运动功能部分障碍。结论四肢骨折合并主要血管损伤要早期诊断、及时和正确处理,才可能获得良好的临床治疗效果。

Clinical treatment for the fractures of the extremities with major vascular injuries

Objective To study the clinical effects of the emergency treatment for the fractures of the extremities with major vascular injuries. Methods Forty-four cases were respectively conducted by interlocking intramedullary pin fixation, plate and screw fixation, plate and screw fixation orex- ternal brace fixation according to the injury conditions of the fractures. Then, vascular injuries were flexibly delt with direct repair end-to-end anastomosis or blood vessel grafting. Results All patients were followed up for 6 months-3 years.There was no necrosis of extremities and all wound healed well. Of these 45 cases, 6 bone nonunions were found, 7 cases recovery failure occured for nerve injury.Conclusion fractures of the extremities with major vascular injuries should be diagnosed promtly to be conducted properly. In this way, better outcome would be obtained.