Kreder H J, Armstrong P
Division of Orthopaedic Surgery, University of Washington, Seattle 98104, USA.
J Pediatr Orthop. 1995 Jul-Aug;15(4):482-8. doi: 10.1097/01241398-199507000-00015.
Fifty-six open tibia fractures in 55 children were studied retrospectively. The overall case fatality rate was 7% (four patients). The most significant factor affecting death rate was injury to the chest and abdomen. Four amputations were performed in four patients with five injuries. Statistically, the presence of neurovascular compromise was significant, with four of eight compromised extremities (in seven patients) requiring amputation. Infection occurred in eight injuries, for an incidence of 14% overall (50% deep). The most important variables were presence of neurovascular injury and delay in getting the patient to surgery. A delay of > 6 h was correlated with a 25% infection rate compared with a 12% rate for those operated on within 6 h. The average time to union was approximately 5 +/- 4 months (range, 1.5-24.8 months). The most significant factor affecting union time was the age of the patient.
对55名儿童的56例开放性胫骨骨折进行了回顾性研究。总体病死率为7%（4例患者）。影响死亡率的最重要因素是胸腹部损伤。4例患者因5处损伤进行了4次截肢手术。从统计学上看，神经血管受损情况具有显著性，8处受损肢体中有4处（7例患者）需要截肢。8处损伤发生感染，总体发生率为14%（深部感染占50%）。最重要的变量是神经血管损伤的存在以及患者接受手术的延迟情况。延迟超过6小时的感染率为25%，而在6小时内接受手术的患者感染率为12%。平均愈合时间约为5±4个月（范围为1.5 - 24.8个月）。影响愈合时间的最重要因素是患者的年龄。
