摘要
目的：探讨采用血管移植加外固定架固定治疗伴血管损伤的下肢骨折。方法：自2000年8月-2008年1月,收治下肢骨折伴有动脉损伤的患者42例,股动脉损伤4例,月国动脉损伤32例,胫前、后动脉同时损伤6例。血管行大隐静脉移植修复38例,人造血管移植修复4例。骨折均行外固定架固定。结果：2例患者截肢,40例患者保肢成功并获18个月-6年的随访。骨折愈合时间3-8个月,平均4.2个月。病人均能平地行走,膝关节功能按HSS功能评定标准：优5例,良24例,中11例,差2例。踝关节功能评定：小腿部肌肉能主动收缩踝关节活动自如1例,小腿部肌肉能部分主动收缩踝关节部分活动12例,小腿部肌肉无主动收缩踝关节不能自主活动5例。结论：合并血管损伤的下肢骨折在手术过程中为避免再次加重患肢的损伤,以及缩短血管再通所用时间,行外固定架固定骨折简单、快速、有效,再行血管移植修复损伤动脉以恢复血供,可以提高治疗效果。
Objective：To evaluate vascular graft combined with external fixator for treating lower limb fractures associated with vascular injury.Methods： From August 2000 to January 2008,treated lower limb fractures associated with arterial injury in 42 patients,femoral artery injury in 4 cases,32 cases of popliteal artery injury,anterior tibial artery and posterior tibial injury in 6 cases at the same time.Blood vessels were performed by great saphenous vein graft for repair of 38 cases,artificial vascular graft for repair of 4 cases.Fractures by external fixation were performed.Results： 2 patients with amputation,40 patients with successful limb salvage and agreed to 18 months to 6 years of follow-up.Fracture healing time was 3 to 8 months,（an average of 4.2 months）.Patients were able to walk the ground.According to HSS knee score criteria： excellent in 5 cases,good in 24 cases,middle in 11 cases and poor in 2 cases.Evaluation of ankle joint function： a small leg muscles contraction can take the initiative ankle joint so easily in 1 case,a small leg muscle contraction can be the part of the activities of ankle joint in 12 cases and a small leg muscle contraction has non-active activity of ankle joint in 5 cases.Conclusion： During surgery,in order to avoid re-aggravating the injury and shorten the time of limb vascular recanalization,external fixator used in lower limb fractures with vascular injury is simple,fast and effective.Than re-grafting for repair of vascular injury in arteries as to restore blood supply,it can improve therapeutic effect.
出处
《内蒙古医学杂志》
2010年第3期291-293,共3页
Inner Mongolia Medical Journal
关键词
血管损伤
血管移植
外固定术
Vascular injury
Vascular graft
External fixation
