Corain Massimo, Carità Enrico, Vassia Lara, Cugola Landino
U.O. Chirurgia della Mano, Ospedale Policlinico G.B. Rossi, Verona, Italy.
Chir Organi Mov. 2008 Jan;91(1):3-6. doi: 10.1007/s12306-007-0001-8. Epub 2008 Feb 10.
From 1997 to 2003 (7 years follow-up) we treated 33 complex traumas of the upper limbs with the use of external fixation: forearm or humeral complete amputation, complex crash, sometimes with hand crash associated. Often a revascularisation was necessary like as a secondary skin coverage for soft tissue loss or following ischaemic necrosis. Three patients were reluctant to agree to a secondary amputation for large soft tissue necrosis and infection. A high percentage of cases need a successive operation because of bone non-union. Revision of our casistic helps us answer the following: how complex and long is the prognosis of this kind of patient, which are the most important choices we have to make, how important is the length of time taken to make a decision and what are the weak spots in the treatment of these traumas.
从1997年至2003年（7年随访期），我们使用外固定治疗了33例上肢复杂创伤：前臂或肱骨完全截肢、复杂骨折，有时还伴有手部骨折。通常需要进行血管重建，例如作为软组织缺损或缺血性坏死后的二期皮肤覆盖。三名患者因大面积软组织坏死和感染而不愿接受二期截肢。由于骨不连，很大比例的病例需要进行后续手术。对我们的病例进行回顾有助于我们回答以下问题：这类患者的预后有多复杂和漫长，我们必须做出的最重要选择是什么，做出决定所需的时间有多重要，以及这些创伤治疗中的薄弱环节是什么。
