下肢严重创伤:截肢/保肢?

Severe lower extremity trauma: amputation or limb-salvage

下肢严重创伤指的是肢体离断伤或不全离断伤[1]。最常见的不全离断伤是Gustilo III C型损伤即软组织损伤广泛、污染严重、粉碎骨折同时合并血管损伤[2-3]。一些严重的Gustilo III B型损伤也可归入此类。

Severe trauma of the lower extremity is a composite injury including complete and partial amputated limb, such as Gustilo III C and some severe Gustilo III B injuries by different reasons. The treatment of this kind of injury is a choice of limb amputation or limb salvage, however, which is still controversial for how. This article will evaluate the pros and cons of amputation and limb salvage objectively, and emphasize the clinical prospective study of multi-center and multi-discipline for obtaining more scientific and suitable methods for assessment to fit China＇s national conditions, and to help doctors make appropriate treatment decisions. Establishment of regional limb salvage green channel, limb reconstruction working group, and optimized limb salvage process will be put forward to improve the overall treatment of severe lower limb trauma.