骨折内固定并发症的防治

为探讨常见骨折内固定并发症及对策,对螺丝钉、加压滑动鹅头钉、加压钢板、加压髓内钉、交锁髓内钉等治疗各种骨折391例进行分析。结果:螺丝钉断裂3例(0.77％);加压钢板折断4例(1.02％),折弯1例(0.26％);呼吸窘迫综合征2例(0.51％);脑脂肪栓塞1例(0.26％);感染5例(1.28％);金属反应2例(0.51％);骨不连3例(0.77％);畸形愈合5例(1.28％);螺丝钉松动2例(0.51％)。认为严格掌握手术指征、选择合适内固定材料、遵循清创原则、固定符合生物力学及合理使用抗生素可防止和减少并发症的发生。

Prevention and Management of Complications of Internal Fixation of Common Fractures

To evaluate the complications of common fractures treated with internal fixation and discuss the measures for prevention, 391 patients with various kinds of common fractures treated with various types of internal fixation were ana-lyzed. Result: Of the 391 cases, 3 cases (0.77%) were developed screw-breaking, 4 (1.02%) compressive plate -breaking, 1 (0.26%) plate-bending, 3 (0.77%) non-union, 5 (1.28%) deformity union, 5 (1.28%) wound infection, 2 (0.51%) tissue reaction due to metals; 2 (0.51%) screw-loosing, 2 (0.51%) ARDS and 1 (0.26%) fat embolism in the brain. There was no mortality. Authors consider that complications could be prevented by proper determination of the surgical indication, use of the appropriate material for fixation, adherence to the principles of wound management, complying with the biomechanical principles for fixation and proper administration of prophylactic antibiotics.