Seligson D, Henry S L
Department of Orthopedic Surgery, University of Louisville, Kentucky 40292.
Am J Surg. 1991 Jun;161(6):693-701. doi: 10.1016/0002-9610(91)91258-k.
Management of compound fractures remains a challenge to the surgeon. Methods to decrease patient morbidity include early fracture stabilization and sequential débridement. External fixation remains the standard; however, early internal fixation in low-grade injuries may be an acceptable option. Early soft tissue coverage is critical. The use of prophylactic parenteral antibiotics has decreased the incidence of acute infection and chronic osteomyelitis. Supplemental use of local antibiotic polymethyl methacrylate (PMMA) beads appears to further diminish the morbidity in high-grade open fractures.
复合骨折的处理对外科医生来说仍然是一项挑战。降低患者发病率的方法包括早期骨折固定和序贯清创。外固定仍然是标准方法；然而，对于低级别损伤早期进行内固定可能是一个可接受的选择。早期软组织覆盖至关重要。预防性使用胃肠外抗生素降低了急性感染和慢性骨髓炎的发生率。补充使用局部抗生素聚甲基丙烯酸甲酯（PMMA）珠似乎能进一步降低高级别开放性骨折的发病率。
