Reviewing Analysis Treatment Of 64 Cases Limb Disturctive Injury With Different Methods

Objective: To discuss the effect of different methods of debridement and fixation to the destructive injuries.Method: Analyzing cases of destructive injuries in trauma and emergency center in the third hospital of Hebei Medical University from 2008.9 to 2009.9 retrospectively with the memory-mapped, PACS and cases query system. Do debridement to this group of sufferers with the way of high-voltage pulse or persistent low-pressure irrigation, after that fix the fracture with Kirschner wire, external fixture or internal fixture, according to the state of fracture and soft tissue injury. 55 cases are followed up.Result: there are 69 cases in all and we make 64 into our research which have integral medical case of illness data. Assess the surgery on the basis of infection proportion after it, recover of the wound, secondary surgery and length of time in the hospital, 16 cases are excellent and 10 good, 2 poor in the all of 28 cases applied with high-voltage pulse washing method.; while 9 are excellent, 16 good and 11 poor in the 36 cases applied with low-pressure washing; there is significant difference between the two method. The debridement time is between 0.5h to 3h, the mean is1h, and among the 34 cases which less then 1h, 12 are excellent, 13 good and 9 poor; while in the 30 cases which more than 1h, 13 are excellent, 13 good and 4 poor; there is no significant statistic difference between the two group. Among the 34 cases which closed wound immediately, 12 are excellent,16 good and 6 poor; while in all of the 30 cases which closed the wound after, 13 are excellent,10 good and7 poor; there is also no significant statistic difference between the two.55 cases are followed up in which 26 cases are preserved and 29 cases are amputated. Assess the preserved cases according to the fracture heal, outward appearance of the limbs, activity of the arthrosis, 3 cases are excellent and 4 good, 7 poor in the all of 14 cases fixed up with Kirschner wire; while 5 are excellent, 4 good and 1 poor in the 10 cases with external fixture; 1 is excellent, 1 good of the 2 cases with internal fixture; there is significant statistic difference between the Kirschner wire and external fixture group. Assess the 29 amputated cases in basis of if with pain of the limbs, whether can look after themselves, work and society ability,4 are excellent and 10 good,15 poor.Conclusion:high-pressure pulse cleaning is better than continuous Low-voltage irrigation, application of external fixation is better than with Kirschner wire in prognosis of fracture, and reconstruction can produce better function than the amputation.