[开放性骨折中跨学科四肢重建的现代概念]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-06-01 Epub Date: 2024-05-13 DOI:10.1007/s00113-024-01437-x
Benjamin Thomas, Roslind K Hackenberg, Demir Krasniqi, Amr Eisa, Arne Böcker, Emre Gazyakan, Amir K Bigdeli, Ulrich Kneser, Leila Harhaus-Wähner
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引用次数: 0

摘要

整形方法涉及骨科/创伤外科医生、血管外科医生和整形显微外科医生的合作。对于复杂的肢体骨折,目的是优化血流、恢复骨骼稳定性、重建软组织缺损、增强功能和灵敏度。在进行跨学科初步评估后,会尽早使用抗生素并及时进行高质量的清创。随后进行骨折稳定和临时伤口覆盖,以计划最终的跨学科手术。这包括最终的骨合成和软组织重建,在可行的情况下使用局部组织转移,或在大面积创伤区使用游离组织转移。整形方法可以更快地实现最终稳定,减少手术次数,缩短住院时间,降低并发症和翻修率,提高成本效益,改善长期功能。
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[Modern concepts of interdisciplinary extremity reconstruction in open fractures].

The orthoplastic approach involves the collaboration of orthopedic/trauma surgeons, vascular surgeons and reconstructive microsurgeons. In cases of complex limb fractures, the aims are to optimize blood flow, restore bone stability, reconstruct soft tissue defects, and enhance function and sensitivity. The early administration of antibiotics and a timely, high-quality debridement after initial interdisciplinary assessment are carried out. This is followed by fracture stabilization and temporary wound coverage in order to plan the definitive interdisciplinary procedure. This includes definitive osteosynthesis and soft tissue reconstruction, using local tissue transfer if feasible, or free tissue transfer in cases of extensive trauma zones. The orthoplastic approach allows for faster definitive stabilization, fewer operations, shorter hospital stays, lower complication and revision rates, higher cost-effectiveness and improved long-term function.

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