RESUMO
<p><b>OBJECTIVE</b>To discuss the curative effect of the early application of the antibiotic-laden bone cement (ALBC) combined with the external fixation support in treating the open fractures of lower limbs complicated with bone defect.</p><p><b>METHODS</b>From December 2013 to January 2015, 36 cases of lower limb open comminuted fractures complicated with bone defects were treated by the vancomycin ALBC combined with the external fixation support, including 26 males and 10 females with an average age of 38.0 years old ranging from 19 to 65 years old. The included cases were all open fractures of lower limbs complicated with bone defects with different degree of soft tissue injuries. Among them, 25 cases were tibial fractures, 11 cases were femoral fractures. The radiographs indicated a presence of bone defects, which ranged from 3.0 to 6.1 cm with an average of 4.0 cm. The Gustilo classification of open fractures:24 cases were type IIIA, 12 cases were typr IIIB. The percentage of wound infection, bone grafting time, fracture healing time and postoperative joint function of lower limb were observed. The function of injured limbs was evaluated at 1 month after the clinical healing of fracture based on Paley evaluation criterion.</p><p><b>RESULTS</b>All cases were followed up for 3 to 24 months with an average of (6.0±3.0) months. The wound surface was healed well, neither bone infections nor unhealed bone defects were presented. The reoperation of bone grafting was done at 6 weeks after the patients received an early treatment with ALBC, some of them were postponed to 8 weeks till the approximate healing of fractures, the treatment course lasted for 4 to 8 months with an average of(5.5±1.5) months. According to Paley and other grading evaluations of bone and function, there were 27 cases as excellent, 5 cases as good, 3 cases as ordinary.</p><p><b>CONCLUSIONS</b>The ALBC combined with external fixation support was an effective method for early treatment to treat the traumatic lower limb open fractures complicated with bone defects. This method was typified with the advantages such as easy operation, short operation time, overwhelming superiority in controlling infection and provision of good bone grafting bed, a good bone healing can be realized by the use of membrane induction technology for bone grafting.</p>
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ObjectiveTo explore the etiology, comolication a nd causes of death of hospitalized preterm infants. MethodsM aternal and neonatal medical records of 834 hospitalized preterm infants from Ja nuary 1991 to Decembre 2001 were reviewed.ResultsThe statist ics showed that there was an increased tendency of hospitalized preterm infants year by year. Most of them have a definite etiology of prematurity. There were m ore cases hospitalized in winter than in other seasons. 87.6% of preterm infants were associated with different complications. The morbidity of cold injury, pne umonia, recurrent apnea and intracranial hemorrhage declined in last 6 years. Si xty-four babies died, the mortality rate was 7.7%. The smaller the gestational age and birth weight was, the higher the mortality would be. The risk factors of death were birth weight, gestational age, Apgar score at 1 minute after birth, pulmonary hemorrhage and hyaline membrane disease.Conclusion It is important to enforce the perinatal health care and the co-operation of ob stetricians and pediatricians to reduce the complications of prematurity. We sho uld set up a well organized district perinatal transport system, raise the effic iency of rescue management, reduce the mortality and improve the prognosis of pr eterm infants.