Lüscher J N, Rüedi T h, Allgöwer M
Helv Chir Acta. 1978 May;45(1-2):39-42.
A consecutive series of 131 comminuted fractures of the femur in 123 patients has been reviewed. All fractures were stabilized by means of rigid ASIF-plate fixation (mostly DCP). About 60% of the patients were polyfractured or polytraumatized (including brain, chest and abdominal injuries). In 85% of the cases the fracture was stabilized within 24 h after the accident and usually the patients remained on a ventilator with PEEP for 1 to 2 days postoperatively. Of the 4 postoperative deaths only two patients died of a pulmonary complication. All patients could be reexamined 1-3 years postoperatively. Although a number of them had suffered from complications (osteitis, fatigue fractures of the plate, delayed union) and had to be reoperated,92% of the cases displayed an excellent or good functionl result. The factors to reduce the complication rate(i.e. primary cancellous bonegraft) are being discussed.
回顾了123例患者的131例股骨干粉碎性骨折连续病例。所有骨折均采用坚固的AO/ASIF钢板固定(大多为动力加压钢板)。约60%的患者为多发骨折或多发伤(包括脑、胸和腹部损伤)。85%的病例在事故后24小时内完成骨折固定,术后患者通常需使用呼气末正压通气(PEEP)呼吸机1至2天。4例术后死亡患者中,仅2例死于肺部并发症。所有患者术后1至3年都能接受复查。尽管其中一些患者出现了并发症(骨炎、钢板疲劳骨折、骨愈合延迟)并需要再次手术,但92%的病例功能结果为优或良。文中还讨论了降低并发症发生率的因素(如一期松质骨植骨)。