闭合性骨折软组织损伤及修复的评价与处理

Evaluation and management of soft tissue healing induced by closed fracture

对软组织损伤严重性的判断不仅是对患者评价的一个重要组成部分,而且也影响着闭合性骨折的处理。软组织对钝器伤的反应包括微血管反应和炎症性过程。经免疫力低下的软组织作切口可以导致伤口裂开以及深部感染。因此,充分认识软组织的损伤程度是闭合性骨折得以有效治疗的基础。许多处理方法,包括夹板固定、冷冻疗法、压迫和延期手术,有利于限制软组织进一步损伤,有利于术前软组织的自身快速修复。新近出现的外科技术不仅改善治疗效果,也降低了软组织并发症的发生率。

The criterion of injury severity is an important part of evaluation, which can affect the treatment for closed fracture. The reaction in soft tissue healing process contains microvascular responses and inflammation. Take soft tissue with low immunity as a incision will lead to wound dehiscence and deep infection. Therefore, realization of injury severity lays a foundation for effective treating with closed fracture. Many treatment methods, such as splint fixation, cryotherapy, compression or delayed operation, can prevent soft tissue from a second injury, and promote self-repair ability prior to operation. The newly development surgical technique can improve efficacy of therapy, meantime, decrease the incidence of complications.