| 胫骨平台骨折术后早期并发症的处理与分析 |
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投稿时间：2015-06-12
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| 作者 | Author | 单位 | Address | E-Mail |
| 李永山 |
LI Yong-shan |
上海市同仁医院骨科, 上海 200336 |
Department of Orthopaedics, Zhongshan Hospital of Shanghai, Shanghai 200032, China |
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| 董健 |
DONG Jian |
上海中山医院骨科, 上海 200032 |
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dong.jian@zs-hospital.sh.cn |
| 岳雄 |
YUE Xiong |
上海市同仁医院骨科, 上海 200336 |
Department of Orthopaedics, Zhongshan Hospital of Shanghai, Shanghai 200032, China |
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| 蔡振宇 |
CAI Zheng-yu |
上海市同仁医院骨科, 上海 200336 |
Department of Orthopaedics, Zhongshan Hospital of Shanghai, Shanghai 200032, China |
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| 匡垓下 |
KUANG Gai-xia |
上海市同仁医院骨科, 上海 200336 |
Department of Orthopaedics, Zhongshan Hospital of Shanghai, Shanghai 200032, China |
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| 吴宗明 |
WU Zong-ming |
上海市同仁医院骨科, 上海 200336 |
Department of Orthopaedics, Zhongshan Hospital of Shanghai, Shanghai 200032, China |
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| 何洁铭 |
HE Jie-ming |
上海市同仁医院骨科, 上海 200336 |
Department of Orthopaedics, Zhongshan Hospital of Shanghai, Shanghai 200032, China |
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| 李一凡 |
LI Yi-fan |
上海市同仁医院骨科, 上海 200336 |
Department of Orthopaedics, Zhongshan Hospital of Shanghai, Shanghai 200032, China |
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| 徐志英 |
XU Zhi-ying |
上海市同仁医院骨科, 上海 200336 |
Department of Orthopaedics, Zhongshan Hospital of Shanghai, Shanghai 200032, China |
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| 期刊信息：《中国骨伤》2015年，第28卷，第9期，第846-849页 |
| DOI：10.3969/j.issn.1003-0034.2015.09.014 |
| 基金项目:上海市科委医学重点项目(编号:12411951300) |
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中文摘要:
目的:探讨胫骨平台骨折术后早期并发症原因和对策.
方法:回顾分析2003年12月至2013年12月行切开复位钢板和部分植骨内固定术后出现早期并发症的38例胫骨平台患者,男35例,女3例;年龄37~69岁,平均42.3岁.骨折按Schatzker分型:Ⅱ型3例,Ⅲ型2例,Ⅳ型2例,Ⅴ型19例,Ⅵ型12例.伤后至手术时间9 h~9 d,伤后3 d内手术26例.钢板固定15例,钢板加同种异体骨固定23例.皮肤坏死15例,感染6例,骨筋膜室综合征3例,腓总神经损伤2例,腓浅神经损伤3例,腘动脉损伤2例,骨折复位不良7例.
结果:14例伤口Ⅰ期愈合,24例伤口延期愈合.住院时间7~67 d,平均25.6 d.38例均获随访,时间12~36个月,平均16.4个月.骨折愈合时间3~9个月,平均6.9个月.末次随访采用Merchant标准评定下肢功能:优19例,良12例,可5例,差2例.
结论:胫骨平台骨折术后早期并发症与骨折严重程度密切相关,与术前准备不足、合并症的治疗、手术时机选择和手术技术有关;术后密切观察,早期发现及时处理减少损害. |
| 【关键词】胫骨骨折 骨折固定术,内 手术后并发症 |
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| Treatment and analysis of the early postoperative complications of tibial plateau fractures |
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ABSTRACT
Objective: To analysis the early complications of tibial fracture and its related factors, and propose a solution.
Methods: From December 2003 to December 2013, 38 patients with early complications of tibial plateau fracture after operation were retrospectively analyzed. There were 35 males and 3 females, aged from 37 to 69 years old (averaged 42.3 years). According to Schatzker classification, 3 cases were classified as typeⅡ, 2 cases as typeⅢ, 2 cases as type Ⅳ, 19 cases as type Ⅴ, 12 cases as type Ⅵ. The intervals between injury and operation ranged from 9 hours to 9 days, 26 cases within 3 days. Fifteen cases were treated with internal fixation of plates and 23 were treated by plate fixation and bone transplantation. Early complications included skin necrosis in 15 cases, infection in 6 cases, osteofascial compartment syndrome in 3 cases, common peroneal nerve injury in 2 cases, the superficial peroneal nerve injury in 3 cases, popliteal artery injury in 2 cases, loss of reduction in 7 cases.
Results: The wound of 14 cases healed at the first stage and 24 cases healed delay. Hospitalization days ranged from 7 to 67 days (averaged 25.6 days). All patients were followed up for 12 to 36 months with an average of 16.4 months. The fracture healing time ranged from 3 to 9 months (averaged 6.9 months). According to Merchant knee function evaluation criteria, the results were excellent in 19 cases, good in 12, fair in 5 and poor in 2.
Conclusion: Early complications of tibial fracture after operation is closely associated with the severe fracture complexity and related with preoperative preparation, surgical timing, operation incision selection and surgical technique. Early detection and timely processing reduce damage. |
| KEY WORDS Tibial fractures Fracture fixation, internal Postoperative complications |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李永山,董健,岳雄,蔡振宇,匡垓下,吴宗明,何洁铭,李一凡,徐志英.胫骨平台骨折术后早期并发症的处理与分析[J].中国骨伤,2015,28(9):846~849 |
| 英文格式: | LI Yong-shan,DONG Jian,YUE Xiong,CAI Zheng-yu,KUANG Gai-xia,WU Zong-ming,HE Jie-ming,LI Yi-fan,XU Zhi-ying.Treatment and analysis of the early postoperative complications of tibial plateau fractures[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(9):846~849 |
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