| 高海拔地区下肢开放性骨折的治疗体会 |
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投稿时间：2021-08-12
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| 作者 | Author | 单位 | Address | E-Mail |
| 邓江涛 |
DENG Jiang-tao |
陆军第九五二医院创伤骨科, 青海 格尔木 816099 |
Department of Trauma Orthopaedics, Army 952 Hospital, Golmud 816099, Qinghai, China |
yq_djt@126.com |
| 高建华 |
GAO Jian-hua |
陆军第九五二医院创伤骨科, 青海 格尔木 816099 |
Department of Trauma Orthopaedics, Army 952 Hospital, Golmud 816099, Qinghai, China |
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| 曲恒顺 |
QU Heng-shun |
陆军第九五二医院创伤骨科, 青海 格尔木 816099 |
Department of Trauma Orthopaedics, Army 952 Hospital, Golmud 816099, Qinghai, China |
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| 程欢 |
CHENG Huan |
陆军第九五二医院创伤骨科, 青海 格尔木 816099 |
Department of Trauma Orthopaedics, Army 952 Hospital, Golmud 816099, Qinghai, China |
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| 孙士奎 |
SUN Shi-kui |
陆军第九五二医院创伤骨科, 青海 格尔木 816099 |
Department of Trauma Orthopaedics, Army 952 Hospital, Golmud 816099, Qinghai, China |
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| 杨学涛 |
YANG Xue-tao |
陆军第九五二医院创伤骨科, 青海 格尔木 816099 |
Department of Trauma Orthopaedics, Army 952 Hospital, Golmud 816099, Qinghai, China |
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| 期刊信息：《中国骨伤》2021年，第34卷，第12期，第1132-1135页 |
| DOI：10.12200/j.issn.1003-0034.2021.12.008 |
| 基金项目: |
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中文摘要:
目的：探讨高海拔地区下肢开放性骨折的治疗方法及经验。
方法：回顾性分析自2016年1月至2021年1月采用损伤控制骨科理念分阶段手术，重视创面处理，结合多种骨折固定方法治疗的62例下肢开放性骨折患者，男51例，女11例，年龄14~59（37.2±12.3）岁，病程7~59（23.7±15.5） d。所有患者伴有皮肤软组织损伤的开放性骨折，按Gustilo-Anderson分型，Ⅰ型14例，Ⅱ型24例，ⅢA型14例，ⅢB型8例，ⅢC型2例。观察骨折修复及创面愈合情况，并采用Johner-Wruhs评价标准进行临床疗效评价。
结果：55例获得随访，时间4~36（14.7±8.5）个月，7例失访。根据Johner-Wruhs评价标准，优33例，良16例，中4例，差2例。2例创面愈合差，1例跟腱部分坏死，1例骨折不愈合，2例骨折延迟愈合。
结论：重视软组织损伤的处理及创面保湿的管理，对骨折分阶段手术并充分保护骨折端血运，是治疗高海拔地区下肢开放性骨折患者的有效方法。 |
| 【关键词】骨折,开放性 下肢 高海拔地区 |
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| Treatment of open fracture of lower limb in high altitude area |
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ABSTRACT
Objective: To explore the treatment methods and experience of open fracture of lower limb in high altitude area.
Methods: From January 2016 to January 2021,62 patients with open fractures of lower limbs were treated by staged surgery with the concept of injury control orthopedics,emphasizing wound treatment and combining various fracture fixation methods. There were 51 males and 11 females,ranging in age from 14 to 59 years old,with a mean of(37.2±12.3) years old;and the course of disease ranged from 7 to 59 days,with a mean of (23.7±15.5) days. According to Gustilo Anderson classification,there were 14 cases of typeⅠ,24 cases of typeⅡ,14 cases of typeⅢA,8 cases of typeⅢB and 2 cases of typeⅢC. The fracture repair and wound healing were observed,and the clinical efficacy was evaluated by Johner-Wruhs evaluation standard.
Results: Fifty-five patients were followed up,and the duration ranged from 4 to 36 months,with a mean of (14.7±8.5) months,and 7 cases were lost to follow-up. According to Johner-Wruhs evaluation criteria,33 cases got an excellent result,16 good,4 poor and 2 bad. The wound healing was poor in 2 cases,partial necrosis of Achilles tendon in 1 case,nonunion of fracture in 1 case and delayed healing of fracture in 2 cases.
Conclusion: It is an effective method to treat the open fracture of lower extremity in high altitude area to pay attention to the management of soft tissue injury,the management of wound moisturizing,staged operation of fracture and full protection of blood supply at the fracture end. Paying attention to the treatment of soft tissue injury and the management of wound moisturizing,staged operation of fracture and full protection of blood supply at the fracture end are effective methods for the treatment of open fracture of lower limbs in high altitude areas. |
| KEY WORDS Fracture,open Lower extremities High altitude areas |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 邓江涛,高建华,曲恒顺,程欢,孙士奎,杨学涛.高海拔地区下肢开放性骨折的治疗体会[J].中国骨伤,2021,34(12):1132~1135 |
| 英文格式: | DENG Jiang-tao,GAO Jian-hua,QU Heng-shun,CHENG Huan,SUN Shi-kui,YANG Xue-tao.Treatment of open fracture of lower limb in high altitude area[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(12):1132~1135 |
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