中重度烧伤合并四肢骨折的治疗

目的:探讨中重度烧伤合并四肢骨折的治疗方法。方法:回顾性分析4例中重度烧伤合并四肢骨折的处理过程。在纠正低血容量、控制休克后的48h内,根据骨折移位情况,1例仅给予石膏托固定,3例分别给予钢板、克氏针、带锁髓内针固定。3⁷d后再给予切痂或削痂植皮。结果:4例经过1次或多次植皮,伤口愈合。随访13个月,所有骨折均愈合,无骨髓炎、化脓性关节炎发生。2例因瘢痕挛缩出现膝或踝关节屈伸功能受限。结论:烧伤48h内在烧伤部位行骨折的复位手术,不会增加感染的风险,且有利于烧伤的处理及骨折的愈合。

Treatment of extremity fractures with moderate-severe burn

Objective: To discuss the therapeutic method of extremity fracture in combination with moderate-severe burn.Methods: The treating process of 4 patients with extremity fracture and moderate-severe burn were retrospectively analyzed.During 48 hours of corrected hypovolemia and controling shock,the fractures were fixed by plaster support,steel plate,Kirschner wire,intramedullary interlocking nailing respectively according to the displacement of fracture.3-7 days after operation,the excision of eschar and dermatoplasty were done in all patients.Results: The wound of all patients healed through dermatoplasty.During the 13 months follow up,all the fractures healed,on osteomyelitis or pyogenic arthritis occured.Two cases had knee or ankle joint functional handicap because of scar contracture. Conclusion: Reduction during the 48 hours after fire burn will not increase infected risk but in favour of burnt treatment and fracture healing.