双股骨干骨折治疗方式的选择

报告双股骨干骨折23例的治疗结果,年龄4.5～47岁,平均合并损伤3.1处。属股骨开放性骨折12侧,按Gustilo分类:Ⅰ型2侧,Ⅱ型5侧,Ⅲ型5侧。全组死亡2例,余21例行双侧牵引治疗4例,1侧牵引、1侧手术治疗2例,双侧手术治疗15例。平均随访3.8年,平均骨愈合时间3.6个月,手术者无1例发生深部感染,功能属正常或基本正常33侧(78.6％)。作者认为:双股骨干骨折的治疗,应根据合并伤的轻重、骨折类型、开放损伤程度及患者年龄来决定治疗方式,对成人应尽量采用手术治疗,而对儿童则首选仍为牵引。必要时可行1侧手术,1侧非手术或双侧手术以简化治疗,利于骨折愈合及其他伤情的恢复。

Treatment of Bilateral Femoral Shaft Fratures

The results of 23 patients with bilateral femoral shaft fractures were reported. The age at the time of injuries was 4. 5 to 47 years. The average combined injury was 3. 1. There were 12 open fractures, two of the open fracture were Grade I ,five Grade I , and five Grade I .according to the criteria of Gustilo . The methods of operation included intramedullary nailing,Ender nailing and traction. All the patients were followed in an average time of 3. 8 years. All fractures had healed clinically in an average of 3. 6 months. The function of 33 lower limbs(78. 6%)was normal or near normal. We believe that operative fixation of the femur is a good tratment option for patients who have bilateral femoral shaft fracture and multiple injuries.