UNASSIGNED: A retrospective analysis was conducted on the clinical characteristics, treatment methods, and outcomes of a case involving a 10.5 cm extruded segment of the femur in a 9-year-old male with a right femoral comminuted fracture treated at our center. Additionally, a retrospective review and summary were conducted on all reported cases of open fractures with impacted bone segments in the lower limbs.
UNASSIGNED: Our center treated a 9-year and 11-month-old male child who presented with a Gustilo type IIIB open fracture of the femur along with a large segment of the femur being ejected as a result of a car accident. The child was resuscitated to correct hypovolemic shock, underwent emergency wound debridement, and had Ilizarov external fixation of the femur. The ejected femur segment was sterilized using ethylene oxide and re-implanted four days after the injury. A literature review showed that out of the cases of open fractures with impacted bone segments in the lower limbs, there were 14 cases involving the femur and 5 cases involving the tibia. Among them, sterilization was performed using povidone-iodine in 6 cases, high-pressure steam sterilization in 3 cases, and other methods including gamma-ray irradiation and soaking in antibacterial solution were used in the remaining cases. In terms of surgical methods, 7 cases were fixed with locking plates, 3 cases were fixed with external fixation devices, 1 case was immobilized in a cast, 1 case was fixed with an intramedullary rod, and 4 cases involved a combination of external fixation and internal fixation. The average time for re-implantation was 7.6 days after the injury. There were no serious complications such as infection or non-union observed in any of the cases during follow-up.
UNASSIGNED: Ethylene oxide can be considered a reliable choice for the reimplantation of displaced bone segments in open fractures after sterilization.
■对其临床特征进行了回顾性分析,治疗方法,以及在我们中心治疗的一名9岁男性右股骨粉碎性骨折的10.5cm股骨突出段的病例的结果。此外,我们对所有报道的下肢开放性骨折伴骨节段受累的病例进行了回顾性回顾和总结.
■我们的中心治疗了一名9岁11个月大的男性儿童,该儿童表现为GustiloII1B型股骨开放性骨折,并有大部分股骨因车祸而被弹出。这个孩子被复苏以纠正低血容量休克,接受了紧急伤口清创术,并对股骨进行了Ilizarov外部固定。使用环氧乙烷对排出的股骨段进行灭菌,并在受伤后四天重新植入。文献综述显示,在下肢开放性骨折伴骨节段受累的病例中,其中股骨14例,胫骨5例。其中,6例使用聚维酮碘进行灭菌,高压蒸汽灭菌3例,其余病例采用伽马射线照射和抗菌溶液浸泡等方法。就手术方法而言,7例采用锁定钢板固定,3例采用外固定器固定,1例固定在铸型中,1例用髓内棒固定,4例采用外固定和内固定相结合。平均再植入时间为损伤后7.6天。随访期间未出现感染或不愈合等严重并发症。
■环氧乙烷可以被认为是灭菌后开放性骨折中移位骨段再植入的可靠选择。