Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO 80204, USA.
J Orthop Trauma. 2010 Feb;24(2):107-14. doi: 10.1097/BOT.0b013e3181b6bdfc.
The ideal timing and modality of femur shaft fracture fixation in head-injured patients remains a topic of debate. Several groups advocate the immediate definitive fixation of femur fractures ("early total care"), whereas others support the concept of "damage control orthopaedics" with temporary fracture fixation by means of external fixation and staged, planned conversion to internal fixation. The present review was designed to address this unresolved controversy by outlining the underlying immunopathophysiology of traumatic brain injury and providing clinical recommendations on the timing of femur shaft fracture fixation in patients with severe head injuries.
股骨干骨折在颅脑损伤患者中的理想固定时机和方式仍存在争议。一些学者主张立即行确定性固定（“早期全面治疗”），而另一些学者则支持“损伤控制骨科”理念，即通过外固定临时固定骨折，分期、计划性转为内固定。本综述旨在通过阐述创伤性脑损伤的潜在免疫病理生理学，并就严重颅脑损伤患者股骨干骨折固定的时机提供临床建议来解决这一未解决的争议。
