多发伤中长骨干骨折的早期髓内固定

目的 探讨多发伤中长骨干骨折的处理时机和方法。方法 共１６６例多发伤中长骨干骨折，伤员损伤严重度评分（ＩＳＳ）平均为２１．６分，伴休克者３９例（２３．５％０，８３％的伤员在到院后２４小时内（９５％在４８小时内）施行手术治疗，２０４处长骨干骨折（包括６６处开放骨折）均采用髓内固定。结果 伤口一期愈合率９５％，骨折愈合率继９３％，未发生脂肪栓塞、急性呼吸窘迫综合征（ＡＲＤＳ）深静脉炎和多器官功能衰竭（ＭＯＦ）等并发症。结论 对多发伤中长骨干骨折早期复位和髓内固定有利于稳定伤员病情、减少并发症、提高治愈率和降低死亡率。

Early Intramedullary Fixation for Diaphyseal Fractures of the Long Bone in Polytrauma

objective: To explore the optim time and methods of treatment of diaphyseal fractures in polytrauma.Methods:A restrospective study of 166 cases was conducted of which 204 had diaphyseal fractures.The average ISS was 21.6 for each case.39 cases were associated with shock.The early operation was done for 83% of the cases in 24 hours(95% of the cases in 48 hours) after admittion.204 long bone diaphysis fractures were fixed with intramedullary fixation.Results: The rate of primary healing was 95% and the healing rate of fractures was 93%.No systemic complications including Fat Embolism,ARDS,Phlebitis and MOF occurred.Conclusion: The long bone diaphysis fractures in polytrauma should be treated with early reduction and intramedullary fixation and it was proved to be beneficial in preventing systemic complications,reducing the mortality,increasing the rate of the healing and providing a better rehabilitation and functional result.