Nast-Kolb D, Waydhas C, Jochum M, Spannagl M, Duswald K H, Schweiberer L
Chirurgische Klinik Innenstadt, Universität München.
Chirurg. 1990 Apr;61(4):259-65.
Despite the wide-spread opinion, that early stabilisation of femur fractures in multiply injured patients is of advantage, there are no publications that unambiguously prove this statement. In contrast, primary fracture stabilisation of the femur with concomitant thoracic trauma seems to increase the rate of complications. The biochemical data of the prospective study presented here suggest, that operative stabilisation of femoral fractures imposes an additional trauma on the already compromised organism. The period between days 2 to 4, when the primary activation of humoral and cellular mediators has returned to normal levels, seems to be the best time for osteosyntheses of these fractures. The operation in this period allows intramedullary fixation--the biologically and biomechanically best fixation procedure--with low risk.
尽管普遍认为，对多发伤患者的股骨骨折进行早期固定具有优势，但尚无明确证明这一说法的出版物。相反，股骨骨折的一期固定伴随胸部创伤似乎会增加并发症发生率。本文前瞻性研究的生化数据表明，股骨骨折的手术固定会给本已受损的机体带来额外创伤。在第2至4天期间，体液和细胞介质的初次激活已恢复到正常水平，这似乎是这些骨折进行骨合成的最佳时机。在此期间进行手术可以采用髓内固定——生物学和生物力学上最佳的固定方法——且风险较低。
