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股骨下段骨折合并血管损伤的早期修复
Hits: 2126   Download times: 1370   Received:February 01, 2007    
作者Author单位UnitE-Mail
章柏平 ZHANG Bai-ping 解放军第一八四医院骨科,江西鹰潭335000 Department of Orthopaedic, the 184th Hospital of PLA,Yingtan 335000,Jiangxi,China  
吕仁发 LV Ren-fa 解放军第一八四医院骨科,江西鹰潭335000 Department of Orthopaedic, the 184th Hospital of PLA,Yingtan 335000,Jiangxi,China  
徐燕荣 XU Yan-rong 解放军第一八四医院骨科,江西鹰潭335000 Department of Orthopaedic, the 184th Hospital of PLA,Yingtan 335000,Jiangxi,China  
汤善华 TANG Shan-hua 解放军第一八四医院骨科,江西鹰潭335000 Department of Orthopaedic, the 184th Hospital of PLA,Yingtan 335000,Jiangxi,China  
邹澍 ZOU Shu 解放军第一八四医院骨科,江西鹰潭335000 Department of Orthopaedic, the 184th Hospital of PLA,Yingtan 335000,Jiangxi,China  
期刊信息:《中国骨伤》2007年20卷,第8期,第551-552页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:总结股骨下段骨折合并血管损伤处理的经验教训,以降低伤残率。

方法:股骨下段骨折合并血管损伤患者21例,男16例,女5例;年龄1752岁,平均32.3岁。其中股动脉损伤9例,腘动脉损伤12例。全部手术探查,针对不同情况选择血管修复方法。1例因入院时下肢肌肉广泛坏死而行Ⅰ期截肢,自体静脉移植8例,血管吻合7例,血管修补3例,血管结扎2例。

结果:21例患者中,4例截肢,其中1例Ⅰ期截肢,3例Ⅱ期截肢。余患者获124个月随访,平均8.5个月。17例均恢复血运,膝关节功能均恢复满意,其中4例出现足下垂。

结论:①诊断明确后或高度怀疑有血管损伤者应尽早行手术探查。②下肢大静脉修复的好坏对肢体功能的恢复有重要影响。
[关键词]:股骨骨折  血管损伤  修复外科手术
 
Early repair of subfemoral fracture associated with vascular and never injury
Abstract:

Objective:To summarize the experience and learn from early repair of subfemur fracture associated with vascular and nerve injury, so that to reduce the rate of disability.

Methods:There were 21 patients with subfemur fracture associated with vascular and nerve injury involving 16 male and 5 female, the age ranging from 17 to 52 years (mean 32.3 years). Among them, 9 patients had femoral artery injury and 12 had popliteal artery injury. The management was selected according to the type of vascular injuries. One patient was amputated directly. Autogenous vein graft was performed on 8 cases, vascular anastomosis on 7 cases, direct suture on 3 cases, ligation on 2 cases.

Results:Of all patients with vascular injury, 4 cases had undergone amputation, among them, one case were given amputation at one stage, three cases were given amputation at two stages. The other patients survived after operation and were followed-up for 1 to 24 months (mean 8.5 months), but for four cases of footdrop, all knee joint function recovery satisfactorily.

Conclusion:①The surgical exploration should be done as soon as possible when diagnosis of injuries of large arteries is definite or highly suspected. ②Whether large veins of lower limb recovery has effect restoration of limbs function.
KEYWORDS:Femoral fractures  Blood vessel injury  Reconstructive surgical procedures
 
引用本文,请按以下格式著录参考文献:
中文格式:章柏平,吕仁发,徐燕荣,汤善华,邹澍.股骨下段骨折合并血管损伤的早期修复[J].中国骨伤,2007,20(8):551~552
英文格式:ZHANG Bai-ping,LV Ren-fa,XU Yan-rong,TANG Shan-hua,ZOU Shu.Early repair of subfemoral fracture associated with vascular and never injury[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(8):551~552
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