摘要
目的 探讨海水浸泡踝、膝关节开放损伤的治疗。方法 自 1986年 2月至 2 0 0 3年 1月 ,海水浸泡踝、膝关节开放损伤共 4 1例 4 7个关节均于彻底清创后关节内骨折复位内固定 ,一期闭合创面 ,一期行局部皮瓣或肌皮瓣转移修复关节周围软组织明显缺损。结果 皮瓣或肌皮瓣全部存活。创部 /甲愈合 2 5个关节 (占 5 1.2 % ) , /乙愈合 18个关节 (占 38.3% ) ,仅 4个关节出现感染征象 (占 8.5 % )。随访 6个月至 16年 10个月 ,关节内骨折均愈合 ,踝、膝关节功能恢复满意 ,膝关节功能优 6例 ,良 4例 ,可 1例 ;踝关节功能优 14例 ,良 8例 ,可 1例 ,差 1例。但是 ,伤后 5～ 7a以上者均出现不同程度的关节退变表现。结论 海水浸泡时间不超过 2 h、伤后时间在 6～ 8h以内的踝、膝关节开放损伤均可于彻底清创后一期处理关节内骨折和闭合创面 。
Objective To explore surgical procedure for open ankle and/or knee joints injury with seawater immersion.Methods From February 1986 to January 2003, 41 cases with 47 open ankle and/or knee joints injury with seawater immersion for 5～135 minutes were accepted.The joints were thoroughly debrided, then intrarticular fractures were reduced and fixed, one-stage wound closure was employed, and cutaneous or musculocutaneous flaps were transferred locally to repair soft tissue defects.Results Flaps survived, the wound and intrarticular fractures were healed.Followed up for 6 months to 16 years and 10 months function of ankle or knee joints was satisfactory, but degenerative changes were observed in joints with follow up more than 5 to 7 years.Conclusion Reduction and fixation of intrarticular fracture and one-stage closure of the wound could be employed during surgical procedures for open ankle and/or knee joints injury with seawater immersion less than 2 hours, and that local cutaneous or musculocutaneous flaps might be applied to repair soft tissue defects after thorough debridement.
出处
《实用骨科杂志》
2004年第2期131-134,共4页
Journal of Practical Orthopaedics
