爪形接骨板内固定术治疗多发肋骨骨折98例效果观察

目的：探讨爪形接骨板内固定术治疗多发肋骨骨折的适应证、手术时机及切口选择。方法对邢台市人民医院收治的98例多根多处肋骨骨折行肋骨骨折切开复位爪形接骨板内固定手术,观察效果。结果本组无死亡病例；8例术后需呼吸机辅助呼吸,2例切口感染,均治愈；随访未见明显并发症。结论有明显反常呼吸运动、胸廓塌陷、合并需手术处理的胸腹伤、骨折端错位分离、疼痛剧烈者为本术式的适应证；除急诊手术外,骨折后3~7d手术为最佳时机,如果存在较严重的生理功能紊乱,7 d后手术较为安全；切口选择以减少损伤和利于暴露为原则。

Clinical Effect of Internal Fixation with Claw Type of Blade Plate in Treatment of 98 Patients with Multiple Rib Fractures

Objective To investigate operative indication, operation time and surgical incision of internal fixa-tion with claw type of blade plate in treatment of patients with multiple rib fractures. Methods A total of 98 patients with multiple rib fractures were treated with internal fixation by claw type of rib plates, and clinical effect was observed. Results No patient died. 8 patients needed assistor respiration with ventilator after operation. Incision infection was found in 2 patients, and the patients were cured. No obvious complication was found during the follow-up. Conclusion The operative indications include obviously paradoxical respiration movement, chest wall deformity, thoraco-abdominal injury needed operation treatment, malposition and dislocated and disassociation in fracture ends and severe pain com-bined with fracture ribs. The best operation time is 3-7 d after fractures except for emergency operation. If patients have severely physiological dysfunction, safer operation time should be 7 d after fractures. Selecting principles of for surgical incision are decreasing injury and adequate surgical exposure.