Sagray Bryan A
Department of Orthopaedics/Podiatry Division, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA.
J Am Podiatr Med Assoc. 2013 Jan-Feb;103(1):76-80. doi: 10.7547/1030076.
Open fracture-dislocation of the lower extremity poses a serious risk, has a high incidence of complications, and necessitates prompt surgical intervention. Patients need to be evaluated on presentation to the emergency department for neurovascular injury, soft-tissue insult, stability of the fracture, concomitant injuries, and overall medical/nutritional status. Implementation of a specific treatment protocol will decrease time to operative management and increase the overall success rate. Success after treatment of lower-extremity trauma should be defined as a noninfected, functional limb with optimal tissue preservation allowing ambulation. We present a case of open fracture-dislocation of the first ray treated with prompt debridement, skeletal stabilization, and immediate soft-tissue reconstruction.
下肢开放性骨折脱位风险严重,并发症发生率高,需要及时进行手术干预。患者在急诊就诊时需评估神经血管损伤、软组织损伤、骨折稳定性、合并伤以及整体医疗/营养状况。实施特定的治疗方案将减少手术治疗时间并提高总体成功率。下肢创伤治疗后的成功应定义为肢体无感染、功能良好、组织保存最佳且可步行。我们报告一例经及时清创、骨骼固定和立即软组织重建治疗的第一跖列开放性骨折脱位病例。