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首页> 外文期刊>Open Journal of Urology >Internal Fixation of Gunshot Induced Fractures in Civilians: Anatomic and Functional Results of a Standard Protocol at an Urban Trauma Center
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Internal Fixation of Gunshot Induced Fractures in Civilians: Anatomic and Functional Results of a Standard Protocol at an Urban Trauma Center

机译：平民枪击引起的骨折的内部固定：城市创伤中心的标准协议的解剖和功能结果

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Introduction: Despite extensive experience with civilian gunshot fractures or wounds, no consensus exists on a standard protocol to manage these injuries. Many authors recommended immediate debridement, but the optimal timing of internal fixation and the use of antibiotic have not been determined. The purpose of this paper is to present and discuss our experience. Material and methods: In January 2007, a treatment protocol was put in place for the evaluation and management of fractured extremities resulting from civilian gunshot wounds. Sixty-three patients with 64 fractures had been managed by this protocol for gunshot fractures between January 2005 and January 2012. There were 56 male and seven female. Their mean age was 33.1 years (range: 17 - 61 years). Thirteen patients (20.6%) were able to provide a description of the weapon. Only 15 patients had entry and exit wounds. The mean follow-up period was 27 (range, 20 - 58) months. The main factors assessed were the surgical site infection, the fracture union and the functional status. Results: Out of the 63 patients, 14 patients developed a wound infection (five superficial and seven deep infections). Wound infection was significantly associated with associated injuries (p = 0.0388), fractures sites requiring fixation (p = 0.024), the fracture pattern (p = 0.0412), operative modalities (p = 0.0400). There were nine cases (14.1%) of fracture non-union. The mean time to union was 15 weeks (range: 5 - 32 weeks). Five patients developed chronics osteomyelitis. The average SMFA score for all of the patients was 23.8 (range: 0 - 56.3). The mean dysfunctional and bother indexes were 18.3 (range: 0 - 52.7) and 22.6 (range: 0 - 66.1), respectively. The SMFA total score and dysfunction index had a significant correlation based on presence or absence of associated injuries (p < 0.0001). But bother index did not show the same correlation (p = 0.452). The average length of hospital stay was 11.3 days (range: 3 - 64). Conclusion: In civilian’s gunshot induced fractures, internal fixation can be made according to standard protocol, with acceptable result.
机译：简介：尽管在民用枪击骨折或伤口方面拥有丰富的经验，但在管理这些伤害的标准方案上尚无共识。许多作者建议立即进行清创术，但尚未确定内固定和使用抗生素的最佳时机。本文的目的是介绍和讨论我们的经验。材料和方法：2007年1月，制定了治疗方案，以评估和管理平民枪伤造成的四肢骨折。在2005年1月至2012年1月之间，本协议已对63例64例骨折的患者进行了枪击性骨折的治疗。男性56例，女性7例。他们的平均年龄为33.1岁（范围：17-61岁）。 13名患者（20.6％）能够提供有关武器的描述。只有15例患者有进出伤口。平均随访期为27（范围20-58）个月。评估的主要因素是手术部位感染，骨折愈合和功能状态。结果：63例患者中，有14例发生伤口感染（5例浅表感染和7例深部感染）。伤口感染与相关伤害（p = 0.0388），需要固定的骨折部位（p = 0.024），骨折类型（p = 0.0412），手术方式（p = 0.0400）显着相关。骨折不愈合9例（14.1％）。工会的平均时间为15周（范围：5-32周）。五例患者发展为慢性骨髓炎。所有患者的平均SMFA得分为23.8（范围：0-56.3）。平均功能障碍指数和烦扰指数分别为18.3（范围：0-52.7）和22.6（范围：0-66.1）。基于是否存在相关伤害，SMFA总评分与功能障碍指数具有显着相关性（p <0.0001）。但是，麻烦指数没有显示出相同的相关性（p = 0.452）。平均住院时间为11.3天（范围：3-64）。结论：在平民的枪击性骨折中，可以按照标准方案进行内固定，结果令人满意。

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