Pillukat T, Prommersberger K-J
Klinik für Handchirurgie, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Deutschland.
Unfallchirurg. 2011 Jul;114(7):575-86. doi: 10.1007/s00113-010-1874-9.
The primary treatment strongly influences the course and prognosis of hand injuries. Complex injuries which compromise functional recovery are especially challenging. Despite an apparently unlimited number of injury patterns it is possible to develop strategies which facilitate a standardized approach to operative treatment. In this situation algorithms can be important guidelines for a rational approach.
The following algorithms have been proven in the treatment of complex injuries of the hand by our own experience. They were modified according to the current literature and refer to prehospital care, emergency room management, basic strategy in general and reconstruction of bone and joints, vessels, nerves, tendons and soft tissue coverage in detail.
Algorithms facilitate the treatment of severe hand injuries. Applying simple yes/no decisions complex injury patterns are split into distinct partial problems which can be managed step by step.
初始治疗对手部损伤的病程和预后有重大影响。影响功能恢复的复杂损伤尤其具有挑战性。尽管损伤模式看似无穷无尽,但仍有可能制定出有助于对手部手术治疗采取标准化方法的策略。在这种情况下,算法可以成为合理治疗方法的重要指导。
根据我们自己的经验,以下算法已被证明可用于手部复杂损伤的治疗。它们根据当前文献进行了修改,涉及院前护理、急诊室处理、一般基本策略以及骨与关节、血管、神经、肌腱和软组织覆盖的重建等详细内容。
算法有助于严重手部损伤的治疗。通过简单的“是/否”判断,复杂的损伤模式可被分解为不同的局部问题,从而能够逐步进行处理。