严重多发伤患者长骨骨折内固定手术时机选择

Timing of internal fixation for long bone fractures in patients with severe multiple injuries

多发性创伤仍是人类健康的重要威胁之一。长骨骨折是多发伤最常见的伴发损伤。近年来,随着大量临床研究工作的深入,此类患者的诊疗策略已发生了巨大的变化。但关于如何确定多发伤患者肢体骨折内固定的时机仍然充满争议。主要的争议存在两种外科处理方法—早期全面治疗和损伤控制骨科之间如何选择。本文通过回顾相关的文献,综述了对最佳手术时机的认识及演变,简要讨论了严重多发性创伤患者长骨骨折内固定手术时机这个充满争议的问题,以期为此类患者的处理提供帮助.

Polytrauma is one of the main causes of death in the world.Fractures are frequently components of polytrauma patterns.In recent years,many efforts have been made to promote guidelines for the management of these patients.The optimal timing of surgical stabilization of fractures in the multitrauma patient is controversial.Currently controversies per-sist between two orthopedic approaches:the Early Total Care and the Damage Control Orthopedics.An overview of on the orthopedic management of polytrauma patient is provided.The aim of this paper is to review the current literature on orthopedic polytrauma patient and to discuss the optimal timing of surgical stabilization of fractures in the multitrauma pa-tient,in order to provide a practical flowchart.