大面积morel－lavallee损伤合并骨盆骨折的诊疗.docVIP

精品论文 参考文献 大面积Morel－lavallee损伤合并骨盆骨折的诊疗 柳伟　藏磊 通讯作者　杨立辉　孔晓川　安立琨　洪钢 首都医科大学附属北京朝阳医院　北京　朝阳　１０００００ 　　【摘要】　目的　探讨大面积MLL合并骨盆骨折的临床特点及治疗方法.方法　２００６年５月到２０１０年１０月共收治患者５例.其中男性３例,女性２例,年龄３７－５７岁,平均年龄４４．４岁.骨盆骨折按照Tile分型,A 型１例,B型２例,C型２例.MLL发现时间０－７天,平均为２．４天.面积为５％－１３％ TBSA,平均为８．２％TBSA.骨折以骨盆外固定器固定,对MLL切开清创,延期缝合,以中厚皮片闭合创面.结果　１例死于感染中毒性休克.其余４例创面均顺利闭合,愈合时间为４－１０周,平均７周.４例患者共获得１２－３６个月,平均１８．６个月的随访.骨折均愈合,骨折愈合时间８－１４周,平均１２周.Majeed功能评分.本组优１例,良２例,差１例,优良率为７５％．结论　对于大面积的MLL合并骨盆骨折,切开清创、延期缝合以中厚皮片闭合创面,联合应用骨盆外固定器固定,可有效的固定骨盆,降低感染,疗效满意. 【关键词】　骨盆,　骨折,　Morel－lavallee损伤DiagnosisandtreatmentofthelargeMorel－lavalleelesioninco－exsistedwithpelvicfracture　Liu Wei,ZangLei ,YangLi－hui,　etalDepartmentofOrthoＧpaedics,BeijingChaoyang Hospital,CapitalMedicalUniversity,Beijing １０００４３,ChinaCorrespondingauthor:ZangLei,Email:canglei＠２６３．net【Abstract】Objective　TodiscusthestrategeriesfordiagnosisandtreatmentofthelargeMorel－lavalleelesioninco－exsistedwithpevicfracture Methods　Fivepatientsweretreatedatourhospitalfrom May２００６toOctomber２０１０．Theywere３malesand２females,agedfrom３７to５７years (mean,４４．４years)．AccordingtotheTileclassification,onewastypeA,twoweretypeBandtwotypeC．Revisionoftraumascorerangedfrom５．１４５to７．８４１(average,７．００９)．Timefrominjurytodiagnosisrangefrom０to７days(average,２．４days).Thelesionarearangefrom５％to１３％ TBSA((averＧage８．４％ TBSA)．Thefracturesweretreatedwithexternalfixation．TheMLLwasopendebridedanddeferredclosureandcoveredwithsplitthicknessskingraft．Results　Onepatientwasdiedofsepticshock．．Fourlesionwerehealed．Thehealingtimerangedfrom６to１０weeks(avaraged８weeks)．fourpatientswerefollowedupfor１２to３６months(mean,１８．６months)．Fourfractureswerehealing,thehealingtimewas８to１４weeks(avaraged１２weeks)．AccordingtotheMajeedevaluationsystem,thepelvicfractureshealingwasevaluatedaftertreatment:１caseswereexcellent;２casesweregood;１casewaspoor;thegoodtoexcellentratewas７５％Conclusion　IntreatmentofthelargeMorel－lavalleelesioninco－exsistedwithpevicfracture,opendeＧbridmentanddeferredclosureandcoveredwithsplitthicknessskingrafandexternalfixationcaneffec