摘要
目的探讨牛鼻子引流(nose ring drain,NRD)技术结合Ilizarov环形外固定一期治疗GustiloⅢA型Pilon骨折的疗效。方法2017年3月—2019年12月,收治GustiloⅢA型Pilon骨折患者17例。其中男11例,女6例;年龄24~63岁,平均38.2岁。交通事故伤3例,高处坠落伤13例,贯通伤1例。急诊入院13例,骨折手术治疗后创面感染4例。合并腓骨骨折2例、外踝骨折3例。采用NRD技术结合Ilizarov环形外固定一期治疗。结果患者均获随访,随访时间8~12个月,平均9.9个月。创面均Ⅰ期愈合,4例术前感染患者随访期间无复发。17例患者术后3~7个月(平均4.5个月)骨折愈合后拆除外固定物。末次随访时,踝关节Kofoe评分中疼痛评分40~50分,平均44分;功能评分17~27分,平均25分;活动度评分8~18分,平均14分;获优8例,良7例,可1例,差1例。结论NRD技术结合Ilizarov环形外固定一期治疗GustiloⅢA型Pilon骨折,骨折固定及引流效果良好,大大降低了传统治疗方案并发症发生风险,减少了手术次数。
Objective To investigate the effectiveness of the nose ring drain(NRD) technique combined with Ilizarov circular external fixation in treatment of Gustilo ⅢA Pilon fracture. Methods Between March 2017 and December 2019, 17 patients with Gustilo ⅢA Pilon fractures were admitted and treated with NRD technique combined with Ilizarov circular external fixation. Among them, there were 11 males and 6 females;the age ranged from 24 to 63 years, with an average of 38.2 years. There were 3 cases of traffic accident injury, 13 cases of falling injury, and 1 case of penetrating injury. There were 13 cases of emergency admittance and 4 cases of wound infection after surgical treatment.Furthermore, there were 2 cases of fibula fractures and 3 cases of lateral malleolus fractures. Results All patients were followed up 8-12 months, with an average of 9.9 months. All wounds healed by first intention, and 4 patients with preoperative infection had no recurrence during the follow-up. The external fixator was removed after fracture healing in17 patients at 3-7 months after operation(mean, 4.5 months). At last follow-up, the pain score of the ankle joint Kofoe score was 40-50, with an average of 44;the functional score was 17-27, with an average of 25;the mobility score was 8-18,with an average of 14;and the effectiveness was rated as excellent in 8 cases, good in 7 cases, and poor in 1 case.Conclusion For Gustilo ⅢA Pilon fractures, the NRD technique combined with Ilizarov circular external fixation has advantages of good fracture fixation and drainage effects, which greatly reduces the complications of traditional treatment options and the number of operations.
作者
浦绍全
徐永清
吕乾
刘志能
赵永辉
赵泽雨
夏燊
齐欣
曲龙
朱跃良
PUShaoquan;XU Yongqing;LU Qian;LIU Zhineng;ZHAO Yonghui;ZHAO Zeyu;XIA Shen;QI Xin;QU Long;ZHU Yueliang(Department of Orthopaedics,the 920th Hospital of Joint Logistics Support Force,Kunming Yunnan,650032,P.R.China;Department of Orthopedics,People's Hospital of Dongchuan District of Kunming,Kunming Yunnan,654100,P.R.China;Department of Orthopedics,Aerospace 731 Hospital,Beijing,100074,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2021年第2期195-199,共5页
Chinese Journal of Reparative and Reconstructive Surgery
基金
云南省创伤骨科临床医学中心项目(ZX20191001)。
