title: [Investigation on operation timing of limb fractures combined with severe craniocerebral trauma in children].
abstract: OBJECTIVE
  To investigate the best choice of operation opportunity and operation plan for limb fractures combined with severe craniocerebral trauma in children.
  
  
  METHODS
  From January 2005 to July 2012,36 patients with limb fractures and severe craniocerebral trauma were received,including 24 males and 12 females aged from 1 to 13 years old (mean, 6.1 +/- 3.0). The time from injury to hospital was (18.0 +/- 15.0) h. Glasgow coma score were less than 8 with an average of 6.4 +/- 1.3. AIS-ISS score were 25.9 +/- 8.1. Thirteen patients were open fracture, 23 were closed fracture. Patients were divided into immediate operation group (21 patients) received fracture fixation with 24 h, the average time was (15.0 +/- 7.4) h, and delayed operation group (15 patients) received fracture fixation after 24 h, the average time was (165.4 +/- 114.6) h. All patients were treated by open reduction, and 33 cases by internal fixation, 3 cases were external fixation. Operative time, blood loss, fracture healing time and brain trauma,physical trauma, postoperative rehabilitation situation were observed and evaluated.
  
  
  RESULTS
  All patients were healed at stage I ,and no dead, aggravating of coma, disorders of breathing and circulation occurred during operation. Operative time,blood loss,healing time in immediate operation group was (44.5 +/- 25.3) min, (47.1 +/- 36.5) ml, (2.7 +/- 0.5) months, respectively; while in delayed operation group was (87.0 +/- 40.0) min, (112.7 +/- 67.5) ml, (3.8 +/- 1.2) months,respectively; and there were obvious differences between two groups. There was no siginificant meaning in Glasgow coma score and Fugl-Meyer motor function between immediate operation group (4.7 +/- 0.6, 97.9 +/- 2.7) and delayed operation group (4.7 +/- 0.5, 97.7 +/- 3.9) (t = 0.23, P > 0.05; t = 0.11, P > 0.05).
  
  
  CONCLUSIONS
  The condition of limb fractures combined with severe craniocerebral trauma in children is seriously, comfortable surgical opportunity should according to particular case, and immediate operation can performed on the condition of stabled vital signs.
authors.forename: Xin
authors.initials: X
authors.lastname: Jiang
authors.forename: Lang
authors.initials: L
authors.lastname: Suo
authors.forename: Li-Jun
authors.initials: LJ
authors.lastname: Liu
authors.forename: Ming-Xing
authors.initials: MX
authors.lastname: Peng
authors.forename: Xue-Yang
authors.initials: XY
authors.lastname: Tang
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Yang
authors.forename: Dao-Xi
authors.initials: DX
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000601:surgery*; D005121:Extremities / Q000293:injuries / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation; D005593:Fracture Fixation, Internal; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male