Harrington I J, Barrington T W, Evans D C, Malcolm B W, Simmons E H
Can J Surg. 1987 May;30(3):204-6.
Delayed union and nonunion are frequent sequelae of high-energy tibial fractures, particularly compound ones. The authors studied 45 such cases; of these, 20 fractures were compound. The authors analysed the initial management but found no apparent correlation between the initial management of these fractures and subsequent delayed union or nonunion. The Phemister bone-grafting technique was used to achieve union and was considered a safe, efficacious method. Aggressive initial management of the soft-tissue component of tibial fractures is recommended to minimize the possible development of chronic osteomyelitis, a serious complication that occurred in eight patients and necessitated below-knee amputation in three.
骨折延迟愈合和不愈合是高能胫骨骨折常见的后遗症，尤其是开放性骨折。作者研究了45例此类病例，其中20例为开放性骨折。作者分析了初始治疗情况，但发现这些骨折的初始治疗与随后的延迟愈合或不愈合之间没有明显关联。采用菲米斯特植骨技术实现了骨折愈合，该技术被认为是一种安全有效的方法。建议对胫骨骨折的软组织部分进行积极的初始治疗，以尽量减少慢性骨髓炎这一严重并发症的可能发生，8例患者出现了该并发症，3例患者因此需要进行膝下截肢。
