Moed B R, Kellam J F, Foster R J, Tile M, Hansen S T
J Bone Joint Surg Am. 1986 Sep;68(7):1008-17.
Between 1975 and 1983, fifty-seven patients were treated at Sunnybrook and Harborview Medical Centers with immediate internal plate fixation of an open diaphyseal fracture of the forearm. Fifty patients were available for follow-up, which ranged from one to nine years and averaged three years. The injuries were classified on the basis of the extent of soft-tissue injury as defined by Gustilo and Anderson, and consisted of twenty Type-I injuries, nineteen Type-II injuries, and eleven Type-III injuries. The complications included deep infection in two patients and non-union in six. The functional results were excellent or good in 85 per cent of the series. This study demonstrates that immediate stable plate fixation is a beneficial method of treatment of open fractures of the forearm. The results are related to the severity of the initial soft-tissue injury and the surgical technique. Autogenous cancellous bone-grafting at the time of closure of the wound in comminuted fractures in which interfragmental compression cannot be obtained is recommended.
1975年至1983年间，57例患者在桑尼布鲁克医疗中心和海港景医疗中心接受了前臂开放性骨干骨折的即刻钢板内固定治疗。50例患者可供随访，随访时间为1至9年，平均3年。根据Gustilo和Anderson定义的软组织损伤程度对损伤进行分类，包括20例I型损伤、19例II型损伤和11例III型损伤。并发症包括2例深部感染和6例骨不连。该系列中85%的功能结果为优或良。本研究表明，即刻稳定钢板固定是治疗前臂开放性骨折的一种有益方法。结果与初始软组织损伤的严重程度和手术技术有关。对于无法获得骨折块间加压的粉碎性骨折，建议在伤口闭合时进行自体松质骨移植。
