|本期目录/Table of Contents|

[1]赵昌松,张强,张耀,等.HIV 阳性合并陈旧闭合四肢骨折患者的手术治疗[J].传染病信息,2017,06:335-337.
 ZHAO Chang-song,ZHANG Qiang*,ZHANG Yao,et al.Surgical treatment for closed old fractures of the extremities in HIV positive patients[J].Infectious Disease Information,2017,06:335-337.
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HIV 阳性合并陈旧闭合四肢骨折患者的手术治疗(PDF)

《传染病信息》[ISSN:1007-8134/CN:11-3886/R]

期数:
2017年06期
页码:
335-337
栏目:
专题论著
出版日期:
2017-12-20

文章信息/Info

Title:
Surgical treatment for closed old fractures of the extremities in HIV positive patients
作者:
赵昌松张强张耀孙胜李鑫赵汝岗
100015,首都医科大学附属北京地坛医院骨科(赵昌松、张 强、张 耀、孙 胜、李 鑫、赵汝岗)
Author(s):
ZHAO Chang-song ZHANG Qiang* ZHANG Yao SUN Sheng LI Xin ZHAO Ru-gang
Orthopaedic Department, Beijing Ditan Hospital, Capital Medical University, 100015, China
关键词:
HIV 阳性四肢骨折闭合骨折陈旧骨折手术治疗
Keywords:
HIV positive fracture of the extremities closed fracture old fracture surgical treatment
分类号:
R512.91;R638.4
DOI:
10.3969/j.issn.1007-8134.2017.06.005
文献标识码:
A
摘要:
目的 观察HIV 阳性合并陈旧闭合四肢骨折患者的手术治疗效果,为治疗HIV 阳性合并陈旧闭合四肢骨折患者提供参考。方法 回顾性分析2010 年11 月—2015 年6 月HIV 阳性合并陈旧闭合四肢骨折进行手术治疗并获得随访患者资料。受伤至手术时间均大于3 周,术后定期复查,观察骨折愈合情况、疗效及并发症发生情况。结果 入组患者共13 例,均给予围手术期处理,手术方式均采用切开复位内固定植骨术,所有患者顺利完成手术。术后随访平均15 个月,术后骨折愈合时间平均为(5.75±1.67)个月,疗效优良率92.3%。无骨不连及钢板断裂出现,无关节僵硬及静脉血栓发生,无切口感染及HIV 感染相关并发症发生,所有患者骨折均正常愈合。结论 HIV 阳性合并陈旧闭合四肢骨折患者在4 周内手术治疗仍能取得很好的治疗效果。另外,HIV 阳性骨折患者应注意加强围手术期处理。
Abstract:
Objective To observe the effect of surgical treatment for closed old fractures of the extremities in HIV positivepatients, and to provide reference for the treatment of HIV positive patients with closed old fractures of the extremities. Methods Aretrospective analysis on HIV positive patients after surgical treatment for closed old fractures of the extremities from November 2010to June 2015 was performed. The time from injury to the operation was more than 3 weeks. Regular postoperative review was performedto observe fracture healing, efficacy and complications. Results A total of 13 patients were enrolled in the study and perioperativemanagement was strengthened. Open reduction and internal fixation with bone graft were used in the operation. All patients underwentsurgery successfully. The average follow-up period was 15 months. The average fracture healing time was (5.75±1.67) months. Theexcellent and good rate was 92.3%. There were no nonunion, plate breakage, joint stiffness, venous thrombosis, wound infection and HIVinfection related complications, and the fractures of all patients were normally healing. Conclusions Surgical treatment for closed oldfractures of the extremities in HIV positive patients can achieve good results within 4 weeks. The HIV positive fracture patients shouldbe paid attention to strengthen the perioperative management.

参考文献/References

[1] Yong MK, Elliott JH, Woolley IJ, et al. Low CD4 count is associatedwith an increased risk of fragility fracture in HIV-infected patients [J]. J Acquir Immune Defic Syndr, 2011, 57(3):205-210.
[2] Prieto-Alhambra D, Güerri-Fernández R, De Vries F, et al. HIVinfection and its association with an excess risk of clinical fractures:a nationwide case–control study[J]. JAIDS, 2014, 66(1):90-95.
[3] 曹清,马宝通. 锁定加压钢板的临床应用[J]. 中国矫形外科杂志,2008,16(12):930-931.
[4] Mulligan K, Harris DR, Emmanuel P, et al. Low bone mass inbehaviorally HIV-infected young men on antiretroviral therapy:adolescent trials network study 021B[J]. Clin Infect Dis, 2012,55(3):461-468.
[5] Güerri-Fernandez R, Vestergaard P, Carbonell C, et al. HIVinfection is strongly associated with hip fracture risk, independentlyof age, gender, and comorbidities: a population-based cohort study [J]. J Bone Miner Res, 2013, 28(6):1259-1263.
[6] Jellis JE. Orthopaedic surgery and HIV disease in Africa[J]. IntOrthop, 1996, 20(4):253–256.
[7] Harrison WJ, Lewis CP, Lavy CB. Wound healing after implantsurgery in HIV-positive patients[J]. J Bone Joint Surg Br, 2002,84(6):802–806.
[8] Aird J, Noor S, Lavy C, et al. The effect of HIV on early woundhealing in open fractures treated with internal and external fixation [J]. J Bone Joint Surg Br, 2011, 93(5):678-683
[9] Huang WC, Kwon EO, Scardino PT, et al. Radical prostatectomy inpatients infected with human immunodeficiency virus[J]. BJUInt, 2006, 98(2):303–307.
[10] Cacciarelli AG, Naddaf SY, el-Zeftawy HA, et al. Acutecholecystitis in AIDS patients: correlation of Tc-99m hepatobiliaryscintigraphy with histopathologic laboratory findings and CD4counts[J]. Clin Nucl Med, 1998, 23(4):226-228.
[11] Norrish AR, Lewis CP, Harrison WJ. Pin-track infection in HIVpositiveand HIV-negative patients with open fractures treated byexternal fixation: a prospective, blinded, case-controlled study[J].J Bone Joint Surg Br, 2007, 89(6):790-793.
[12] Lin PH, Bush RL, Yao Q, et al. Abdominal aortic surgery inpatients with human immunodeficiency virus infection[J]. Am JSurg, 2004, 188(6):690-697.
[13] Grubert TA, Reindell D, Kastner R, et al. Rates of postoperativecomplications among human immunodeficiency virus-infectedwomen who have undergone obstetric and gynecologic surgicalprocedures[J]. Clin Infect Dis, 2002, 34(6):822-830.
[14] Richardson J, Hill AM, Johnston CJ, et al. Fracture healing inHIV-positive populations[J]. J Bone Joint Surg Br, 2008,90(8):988-994.
[15] Gardner RO, Bates JH, Ng’oma E, et al. Fracture union followinginternal fixation in the HIV population[J]. Injury, 2013,44(6):830-833.
[16] Hao J, Herbert B, Quispe JC, et al. An observational case series ofHIV-positive patients treated with open reduction internal fixationfor a closed lower extremity fracture[J]. Eur J Orthop SurgTraumatol, 2015, 25(5):815-819.

备注/Memo

备注/Memo:
[基金项目] 首都临床特色应用研究基金资助项目(Z131107002213063);北京市卫生和计划生育委员会卫生科技成果和适宜技术推广基金资助项目(TG-2015-05);感染病科国家临床重点专科建设项目
[通信作者] 张强,E-mail: zhangqwte@sina.com
更新日期/Last Update: 2017-12-20