颅脑损伤患者四肢骨折的治疗

目的　探讨颅脑损伤患者四肢骨折的治疗方法。方法　对 1993～ 2 0 0 1年收治的 92例颅脑外伤合并四肢骨折患者临床资料进行分析 ,格拉斯哥评分 3～ 15分。手术治疗 70例 ,保守治疗 2 2例。手术治疗中早期以钢板为主 ,后期以髓内固定为主。结果　患者远期疗效优良率达 85 %。术后并发症 12例 ,其中钢板断裂 3例 ,伤口感染 2例 ,骨折延迟愈合 3例 ,截肢 1例。结论　颅脑损伤患者只要机体情况良好 ,均可早期行骨折内固定治疗。骨折尽量应用髓内固定及闭合复位。术后适当延迟负重时间 ,术后功能康复是取得良好手术疗效的关键。

THE EXTREMITY FRACTURE TREATMENT OF CEREBRAL INJURY PATIENT

Objective To explore the treating method of lo ng bone fracture with cerebral injury patient. Methods 92 cases with cerebral injury complicated with long bone fractures were treated from 1993 to 2001, GCS score 3 to 15. Operations were undergone in 70 cases, non-operati on treatment 22 cases. Earlier period operation treated with compression plate, late period with intramedullary interlocking nail. Results 85% of patients achieved excellent and good results. Postoperative complication 12 c ases: implant breakage in 3, infection in 2, delayed union developed in 3, amput ation in 1. Conclusion Cerebral injury patient can be treated w ith internal fixation in primary, only the body condition is good. The fracture fixation used intramedullary and closed reduction. The patient should properly d elay the time to start weight bearing. Functional rehabilitation should be empha sized postoperatively.