三种方式治疗四肢枪击伤骨折的体会

目的：探讨治疗四肢枪击伤骨折的手术方法及适应证。方法对稳定骨折用单臂外固定架；对粉碎性骨折用 Ilizarov 全环外固定架；对骨缺损的骨折用Ⅰ期短缩原位延长法。结果所有患者伤口愈合良好，无感染，3组骨折平均11个月愈合。有2例膝关节、3例踝关节僵硬，2例下肢用单臂外固定架在负重后畸形。结论 Ilizarov 全环外固定架具有微创和可靠的稳定性。Ⅰ期短缩原位延长法可使骨折端对位良好、愈合牢固，还能将断裂的组织和伤口直接吻合。单臂外固定架与全环外固定架相比稳定性差，在下肢骨折中应少用。

The experience of three methods of treatment the limbs fractures bullet wound

Objective Explore three strain form shot wounded limbs fracture treatment method and indication. Methods the stable fractures with single arm external fixator for comminuted fractures with Ilizarov ring external fixate;For defects of bone fracture with stage 1 shortening longer situ . Results all patients the wounded healed well , no case of infection . Three group Fracture on average 11 months to heal. There are two cases of knee joint and Three cases ankle joint stiffness. Two cases of lower limb got deformity after with single arm external fixative in weight. Conclusion IIizarov ring gr type external fixative with minimally invasive and reliable stability. phase 1shortening phase extension situ can make the fracture carries counterpoint good,healing and firm , also can be the organization of the fracture and the wound directly. But single arm external fixation compared with ring type external fixatior all poor stability,the under limb fracture applications.