Orthopedic treatment for open fracture of lower extremities and soft tissue defects in young children and rapid rehabilitation after operation

This study aims to explore the clinical features of open fracture of lower extremities with soft tissue injury in young children, and its surgical and postoperative rehabilitation methods. A total of 32 children with open fracture of lower extremities and soft tissue injury treated in our department from January 2010 to December 2016 were included into this study. An individualized treatment plan was established according to the characteristics of each patient’s condition, and rapid rehabilitation procedures were carried out after the operation to promote the healing of the wound, and shape and function recovery. In the present study, four children developed superficial infection after the operation, and healed after proper management. Furthermore, two children were found to have osteomyelitis during follow-up after discharge, and healed after they returned to the hospital for debridement. All patients were followed up until fracture healing, and the follow-up duration ranged within 6–15 months, with an average duration of 8.5 months. All patients achieved bony union, and none of the patients had bone exposure. In the curative effect assessment, 24 children were classified as excellent, six children were classified as good, one child was classified as moderate, and one child was classified as poor. The excellent and good rate was 93.75%. Open fracture of the lower extremities commonly occur in the middle and lower segment of the tibia and fibula in children, and is usually combined with soft tissue injury. The correct treatment of fractures, and skin and soft tissue injuries, as well as the rapid rehabilitation of children, are the keys to achieving a good clinical effect.

本研究旨在探讨小儿下肢开放性骨折合并软组织损伤的临床特征及其手术与术后康复方案。本研究纳入2010年1月至2016年12月于我科接受治疗的32例下肢开放性骨折合并软组织损伤患儿。研究团队根据每位患者的病情特点制定个体化治疗方案，术后实施快速康复流程，以促进创面愈合、肢体形态与功能恢复。本研究中，4例患儿术后出现浅表感染，经妥善处理后痊愈；另有2例患儿于出院后随访期间被诊断为骨髓炎，返院行清创术后痊愈。所有患者均随访至骨折愈合，随访时长为6~15个月，平均随访时长8.5个月。全部患者均实现骨性愈合，无一例出现骨外露。疗效评估结果显示，24例患儿评定为优，6例为良，1例为中，1例为差，优良率达93.75%。小儿下肢开放性骨折好发于胫腓骨中下段，常合并软组织损伤。正确处理骨折与皮肤软组织损伤，并对患儿实施快速康复干预，是获得良好临床疗效的关键。