骨折内固定术后迟发性感染早期处理分析

目的:探讨骨折内固定术后迟发性感染的发生原因和早期治疗方法。方法:33例骨折内固定术后并发迟发性感染的患者,男21例,女12例,年龄14~55岁,平均33.5岁,分别行抗炎,窦道搔刮或切开清理,置管冲洗引流等保留内固定物治疗,保留内固定物治疗无效者(9例)行内固定物取出术。术后静脉应用头孢类抗生素14~21 d。结果:33例中,24例保留内固定物成功;4例取出内固定物后骨折愈合;5例假关节形成,内固定物取出后,Ⅱ期行内固定植骨术。33例患者随访8~12个月均无复发征象。结论:骨折内固定术后迟发性感染早期诊断早期治疗具有积极的临床意义,一旦确诊,及时治疗,可有效保留内固定物功能,成功杜绝骨折不愈合。

Early treatment of late-developed infection after open reduction and internal fixation:Analysis of 33 cases

Objective: To explore the reason and early therapeutic methods for late-developed infection after open reduction and internal fixation(ORIF).Methods: Thirty-three patients(21 males,12 females) with the mean age of 33.5 years(range,fourteen to fifty-five years) who had late-developed infection after ORIF were involved in our study.The internal fixation devices were not removed initially,and treatment includes anti-inflammatory,scraping the sinus tract and irrigation.The internal fixations were removed from the patients(9 cases) of no effect with the above treatment.Antibiotics were administered interavenously in all patients about 14-21 days postoperatively.Results: The internal fixations were successfully retained in 24 cases.Among the patients who underwent internal device removal,4 cases obtained bone healing.The other 5 patients,on whom pseudoarthrosis presented,were treated with autologous bone graft and internal fixation subsequently.All cases were followed up for 8-12 months and no evidence of recurrence were observed.Conclusion: The early diagnosis and treatment of the late-developed infection are of great value,which can effectively retain the internal fixation and reduce the possibility of postoperative complications,such as bone nonunion.