Davila Slavko, Mikulić Danko, Davila Neda Jarza, Popović Ljiljana, Zupancić Bozidar
Department of Surgery, University Hospital Center Zagreb, Kispatićeva 12, 10000 Zagreb, Croatia.
Mil Med. 2005 May;170(5):414-7. doi: 10.7205/milmed.170.5.414.
In this retrospective study, 18 patients with war injuries of the shoulder were reviewed to evaluate the technical problems associated with external fixation and to analyze the incidence of infection and late functional results. The average patient age was 28.5 years. All patients were male. Thirteen patients had explosive wounds, whereas five wounds were caused by gunshot missiles. All injuries were extensive in terms of bone and soft tissue defects. Six patients presented with complex injuries involving neurovascular structures. Sixteen patients were treated with external fixation. Application of the proximal pins of the external fixator through the humeral head was possible in eight patients, the scapula served as the site of proximal fixation in four patients, only the clavicle was available for placement of pins in two patients, and both the scapula and the clavicle had to be pinned to achieve proximal stabilization in two patients. In two patients, fixation was not possible and early amputation was performed. Infection was eventually eradicated in all patients, allowing for adequate soft tissue coverage of the wounds. Analysis of functional results at an average of 6 years after the injury showed a considerable degree of functional deficit in most patients.
在这项回顾性研究中，对18例肩部战伤患者进行了评估，以分析外固定相关的技术问题，并分析感染发生率及后期功能结果。患者平均年龄为28.5岁。所有患者均为男性。13例患者为爆炸伤，5例为枪伤。所有损伤均伴有广泛的骨与软组织缺损。6例患者伴有累及神经血管结构的复合伤。16例患者接受了外固定治疗。8例患者可通过肱骨头置入外固定架的近端针，4例患者以肩胛骨作为近端固定部位，2例患者仅可将针置于锁骨，2例患者需同时固定肩胛骨和锁骨以实现近端稳定。2例患者无法进行固定，早期行截肢术。所有患者最终感染均得以根除，伤口获得了足够的软组织覆盖。对受伤后平均6年的功能结果分析显示，大多数患者存在相当程度的功能缺陷。
