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复杂足部损伤:早期及确定性治疗

Complex Foot Injury: Early and Definite Management.

作者信息

Schepers Tim, Rammelt Stefan

机构信息

Trauma Unit, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22660, Amsterdam 1100 DD, The Netherlands.

University Center for Orthopaedics and Traumatology, University Hospital Carl-Gustav Carus, Fetscherstrasse 74, Dresden 01307, Germany.

出版信息

Foot Ankle Clin. 2017 Mar;22(1):193-213. doi: 10.1016/j.fcl.2016.09.014.

Abstract

Complex foot injuries occur infrequently, but are life-changing events. They often present with other injuries as the result of a high-energy trauma. After initial stabilization, early assessment should be regarding salvagability. All treatment strategies are intensive. The initial treatment includes prevention of progression ischemia/necrosis, prevention of infection, and considering salvage or amputation. Definitive treatment for salvage includes anatomic reconstruction with stable internal fixation and early soft tissue coverage followed by aggressive rehabilitation. Prognosis after complex injuries is hard to predict. The various stages of the treatment are reviewed and recommendations are made.

摘要

复杂足部损伤并不常见,但却是改变人生的事件。它们常常因高能量创伤而伴有其他损伤。在初始稳定之后,早期评估应着眼于可挽救性。所有治疗策略都很密集。初始治疗包括预防缺血/坏死进展、预防感染以及考虑保肢或截肢。保肢的确切治疗包括解剖重建并进行稳定的内固定以及早期软组织覆盖,随后进行积极的康复治疗。复杂损伤后的预后难以预测。本文回顾了治疗的各个阶段并给出了建议。

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