Brinker M R, Bailey D E
Fondren Orthopedic Group L.L.P., Texas Orthopedic Hospital, Houston 77030, USA.
J Trauma. 1997 Jan;42(1):11-9. doi: 10.1097/00005373-199701000-00004.
Tibial fractures with an associated vascular injury are a challenging management problem for the orthopedic and vascular surgeon. The effect of a concomitant vascular injury on fracture healing has not been specifically delineated previously.
We performed a retrospective review of 29 fractures of the tibial shaft with an associated vascular injury in 28 patients.
Overall there were 44 vessels injured (38 arterial and six venous). A total of six patients had an amputation performed; patients requiring amputation were significantly older than those without amputation. Fractures with an associated injury to the posterior tibial artery had a significantly higher nonunion rate and a greater number of weeks to union than fractures without this vascular injury.
Outcomes of tibial fractures with an associated vascular injury are poorest in older patients (who are at increased risk of amputation) and those with an injury to the posterior tibial artery (who are at increased risk of delayed union and nonunion).
伴有血管损伤的胫骨骨折对于骨科和血管外科医生来说是一个具有挑战性的治疗难题。先前尚未明确阐述伴随的血管损伤对骨折愈合的影响。
我们对28例患者的29处胫骨干骨折伴血管损伤进行了回顾性研究。
总共44条血管受伤（38条动脉和6条静脉）。共有6例患者接受了截肢手术；需要截肢的患者明显比未截肢的患者年龄大。伴有胫后动脉损伤的骨折不愈合率明显更高，愈合所需的周数也比无此血管损伤的骨折更多。
伴有血管损伤的胫骨骨折在老年患者（截肢风险增加）和伴有胫后动脉损伤的患者（延迟愈合和不愈合风险增加）中预后最差。
