摘要
目的探讨海水浸泡踝、膝关节开放性损伤的治疗方法并分析影响疗效的因素。方法对海水浸泡踝、膝关节开放损伤41例47个关节在彻底清创后行关节内骨折复位、内固定,一期闭合创面,对伴有明显关节周围软组织缺损者则一期行局部皮瓣或肌皮瓣转移修复。结果转移皮瓣或肌皮瓣全部存活。创部Ⅱ/甲愈合25个关节(占53.2%),Ⅱ/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～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5～7年以上者均出现不同程度的关节退行性变表现。结论海水浸泡时间不超过2h、伤后时间在6～8h以内处理的踝、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,局部皮瓣或肌皮瓣转移修复软组织缺损是可行的。
Objective To investigate treatment methods and to analyze factors that affect the treatment of open injury of ankle and/or knee joints after seawater immersion. Methods 41 cases with 47 open ankle and/or knee joint injuries immersed into seawater for 5 to 135 minutes were treated. The joints were thoroughly debrided, then intra-articular 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 surivied, and intra-articular fractures were healed. According to followed-up visits of 6 months to 16 years and 10 months, the function of ankle or knee joints was satisfactory, but degenerative changes were observed in joints 5 to 7 years after the occurence of injury. Conclusions Reduction and fixation of intra-articular fractures and one-stage closure of the wounds could be employed for treating open ankle and/or knee joints injury with no more than 2 hours seawater immersion, within 6 - 8 h after injury local cutaneous or musculocutaneous flaps might be applied to repair soft tissue defects after thorough debridement.
出处
《中华航海医学与高气压医学杂志》
CAS
CSCD
2005年第3期148-150,共3页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
