梯形加压钢板治疗成人股骨干骨折并发症的预防及治疗

作者对梯形自身加压钢板治疗成人股骨干骨折351例并发症的防治进行研究。1986年3月～1998年1月采用梯形钢板治疗成人股骨干骨折351例,随访6个月至11年2月297例305处骨折。并发感染的6例(1.9％),骨不连8例(2.6％),畸形愈合5例(1.6％),再骨折3例(1％),钢板弯曲断裂7例(2.3％),螺钉断裂3例(1％)。9例(3％)经再次手术,最终除1例外,骨折均愈合。关节功能优的186个肢体(61％),良好的98个(32％),15例可(5％),差的6个肢体(2％)。优良率占93％。作者认为清创、引流和灌洗可有效防治创口感染。充分修复骨缺损;在骨折临床愈合,形成连续外骨痂时,肢体才能逐步恢复负重活动,这是防止骨不连、再骨折和钢板破坏的主要措施。

Treatment of Femoral Shaft Fractures with Trapezoid Compression Plate (TCP) in Adults: Prevention and Treatment of Complications

To study the prevention and treatment of complications following treatment of femoral shaft fractures with TCP fixation from March 1986 to January 1998, 351 adult patients with femoral shaft fractures were treated with TCP fixation. Two hundred and ninety six cases with 305 fractures were followed up form 6 months to 11 years and 2 months.Complications included infection occurring in 6 cases (2%), non-union in 8 (2.6%), mal-union in 5 cases (1.6%), and refracture in 3 cases (1%) . Plate breakage occurred in 7 cases (2.3%) and screw breakage developed in 3 cases (1%) .Nine (3%) fractures had to do reoperation. Finally, all the fractures but one had sound union. The func-tions of 186 limbs were rated excellent (61%), 98 good (32%), 15 fair (5%) and 6 poor (2%) .The authors think that debridment drainage and irrigation are effective for preventing from wound infection. In order to avoid non-union, refracture and implant failure, the bone defect should be repaired adequately. The weight - bearing should not be taken until the continuous callus has formed well around the fracture site.