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[1]唐少龍,李鳳平,張維康,等.損傷控制理論在C型Pilon骨折中的應(yīng)用[J].中醫(yī)正骨,2011,23(02):14-17.
　TANG Shao-long*,LI Feng-ping,ZHANG Wei-kang,et al.Damage control theory in C-type pilon fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2011,23(02):14-17.
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損傷控制理論在C型Pilon骨折中的應(yīng)用()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第23卷
期數(shù):
2011年02期
頁(yè)碼:
14-17
欄目:
臨床研究
出版日期:
2011-02-25

文章信息/Info

Title:
Damage control theory in C-type pilon fractures
作者:
唐少龍; 李鳳平; 張維康; 江敞
溫州醫(yī)學(xué)院附屬溫嶺醫(yī)院,浙江 溫嶺 317500
Author(s):
TANG Shao-long*; LI Feng-ping; ZHANG Wei-kang; et al. *
Department of Orthopaedics,Wenling Hospital,Wenzhou Medical University, Wenling 317500,Zhejiang,China
關(guān)鍵詞:
Pilon骨折; 損傷控制理論; 骨折; 閉合性; 急診手術(shù)
Keywords:
Pilon fracture;  damage control theory;  Fracture;  Closed;  emergency surgery.
摘要:
目的:評(píng)估運(yùn)用損傷控制理論治療C型Pilon骨折的近期療效。方法:選取自2006年6月至2009年5月有隨訪(fǎng)記錄的105例C型(AO分型)脛骨Pilon骨折患者,按受傷至手術(shù)時(shí)間分為兩組,急診手術(shù)組23例,傷后8 h內(nèi)行切開(kāi)復(fù)位植骨內(nèi)固定術(shù); 損傷控制組82例,運(yùn)用損傷控制理論對(duì)骨折及軟組織進(jìn)行初步處理,于傷后7～24 d軟組織腫脹消退后行切開(kāi)復(fù)位內(nèi)固定術(shù),必要時(shí)二期術(shù)后3～4個(gè)月行骨折端植骨。術(shù)后觀(guān)察兩組創(chuàng)面及骨折愈合情況,參照Ovadia對(duì)脛骨Pilon骨折的愈合評(píng)價(jià)進(jìn)行踝關(guān)節(jié)功能評(píng)估。結(jié)果:105例患者均獲得7～24個(gè)月,平均16.23個(gè)月隨訪(fǎng)。急診手術(shù)組3例并發(fā)感染,3例刀口裂開(kāi),1例內(nèi)固定物外露,1例骨髓炎; 損傷控制組2例表淺感染,1例刀口裂開(kāi),3例二期植骨。損傷控制組在傷口愈合方面明顯優(yōu)于急診手術(shù)組。所有患者均獲骨折愈合,急診手術(shù)組骨折愈合時(shí)間為(15.0±2.1)周,損傷控制組為(14.4±2.8)周,兩組骨折愈合時(shí)間比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)。參照Ovadia對(duì)脛骨Pilon骨折的愈合評(píng)價(jià):急診手術(shù)組組優(yōu)7例,良10例,可4例,差1例,優(yōu)良率為73.9%; 損傷控制組優(yōu)41例,良32例,可8例,差1例,優(yōu)良率為89.0%,損傷控制組優(yōu)于急診手術(shù)組(P<0.05)。結(jié)論:運(yùn)用損傷控制理論治療高能量脛骨Pilon骨折,并發(fā)癥少,創(chuàng)傷小,功能恢復(fù)好,近期療效滿(mǎn)意。
Abstract:
Objective:To assessment of the treatment of C-type Pilon fracture using damage control theory.Methods:Since June 2006 to May 2009 have recorded 105 cases were followed up for type C(AO classification)Tibial Pilon fracture patients,According to time from injury to surgery were divided into two groups: emergency surgery group, 23 cases of emergency surgery after trauma experts 8h internal fixation open reduction. injury control group 82 cases, the use of damage control theory on the initial fracture and soft tissue treatment, at 7～24 d after injury, soft tissue swelling underwent open reduction and internal fixation, if necessary, After surgery in 3 to 4 months bone fracture line.Wound healing and fracture healing,Were observed after the operative. Reference Ovadia on the healing of tibial fractures Pilon evaluation of the ankle joint functional.Results:105 patients were followed up for 7 to 24 months, an average of 16.23 months. Emergency surgery complicated by infection in 3 patients, 3 cases of incision dehiscence, one case of implant exposure, l cases of osteomyelitis; injury control group 2 cases of superficial infection, 1 case of incision dehiscence, three cases of two bone graft, all patients were fracture healing. Damage control group was better than in the wound healing. Emergency surgery patients of fracture healing time was(15.0 ± 2.1)weeks. Injury control group(14.4 ± 2.8)weeks, emergency damage control surgery group with no significant difference in healing time(P> 0.05). Reference Ovadia on the healing of fractures of the tibia Pilon evaluation: emergency operation group were excellent in 7 cases, good in 10 cases, 4 cases and poor in 1 case, the fine rate was 73.9%; damage control were excellent in 41 cases, good in 32 cases, and 8 cases and poor in 1 case, the fine rate was 89.0%, damage control was better than the emergency operation group(P<0.05).Conclusion:Damage control theory treatment of high energy tibial Pilon fractures, fewer complications, trauma, functional recovery, and recent results were satisfactory.

參考文獻(xiàn)/References:

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相似文獻(xiàn)/References:

[1]宋良軍.切開(kāi)復(fù)位鋼板內(nèi)固定術(shù)治療Pilon骨折[J].中醫(yī)正骨,2015,27(02):54.

更新日期/Last Update: 2011-02-25