外固定支架在严重多发伤并胫腓骨开放性骨折中应用的病例对照研究

目的：探讨早期外固定架固定开放性胫腓骨骨折对严重多发伤患者治疗和预后的影响。方法：采用回顾性对比分析，73例严重多发伤（ISS〉16分）患者按胫腓骨骨折手术方法不同分2组。治疗组42例，男31例，女11例；平均年龄40．2岁；均急诊行清创、骨折复位外固定支架固定术。对照组31例，男22例，女9例；平均年龄42．6岁；均急诊行清创、跟骨牵引术或石膏外固定术。比较两组患者急性呼吸窘迫综合征（ARDS）、多器官功能障碍综合征（MODS）发生情况及病死率、小腿创面感染率、创面及骨折愈合时间。结果：两组的并发症（ARDS）发生率差异有统计学意义，行外固定架治疗组低于对照组（P〈0．05），治疗组感染率明显低（P〈0．05），创面愈合时间明显短。结论：外固定架治疗严重多发伤并胫腓骨开放性骨折，明显减少并发症发生率，降低创面感染率。

Case-clinical studies on the applicator of external fixator in the open tibia and fibula fractured patients with multiple trauma

Objective: To explore the effects of early external fixation for open tibia and fibula fractures on the treatment and prognosis of severe multiple injuries. Methods: Seventy-three patients were reviewed in the study. According to the surgical methods for tibia and fibula fractures,the patients with severe multiple injuries were divided into 2 groups:42 patients in the treatment group,including 31 males and 11 females,with an average age of 40.2 years;31 patients in the control group,including 22 males and 9 females,with an average age of 42.6 years. The patients in treatment group were treated urgently with debridement,diaplasis and fixation with external fixator,and patients in control group were treated urgently with debridement,calcaneal traction or gypsum external fixation. The incidence rate and mortality of ARDS and MODS,wound infection rate,wound healing time,and fracture healing time between the 2 groups was compared. Results: The incidence rate and mortality of complications(ARDS)had significant differences between the 2 groups,those in the treatment group were lower than those in the control group(P<0.05). There were significant decreases in the infection rate and wound healing time in the treatment group. Conclusion: External fixation for severe multiple injuries with open tibia and fibula fracture has been proved to be good,which can significantly reduce the mortality and incidence rate of complications and wound infection rate,promote wound healing.