Vester H, Deiler S
Klinik für Unfallchirurgie, Interdisziplinäres Handzentrum, IHZ, Klinikum rechts der Isar, Ismaningerstr. 22, 81675, München, Deutschland.
Unfallchirurg. 2017 Mar;120(3):237-251. doi: 10.1007/s00113-017-0327-0.
The quality of the reconstruction, follow-up treatment and care determine the treatment outcome of complex hand injuries. The initial estimation and therapy are decisive. Optimal results necessitate a structured approach with strategic planning, including thorough débridement, precise analysis of the resulting defect and loss of function and if possible unilateral reconstruction and well-founded planning of secondary interventions. Within the framework of the detailed patient clarification the perspectives, possibilities and alternatives must be realistically presented. Taking these fundamental strategic steps into consideration, the primary aims of reconstruction and preservation of function, rapid occupational and social reintegration and avoidance of delayed complications can best be realized. There is no standard approach for these extremely variable injuries. Decisive is that even in cases of apparently harmless injuries, the involvement of functional structures must be considered early in the initial stages.
重建、后续治疗与护理的质量决定了复杂手部损伤的治疗效果。初始评估与治疗具有决定性作用。要取得最佳效果，需要采用结构化方法并进行战略规划，包括彻底清创、精确分析由此产生的缺损和功能丧失情况，以及尽可能进行单侧重建和合理规划二次干预措施。在详细了解患者情况的框架内，必须切实地呈现各种观点、可能性和替代方案。考虑到这些基本的战略步骤，重建和保留功能、迅速实现职业和社会重新融入以及避免延迟并发症的主要目标才能得到最佳实现。对于这些极其多样的损伤，不存在标准的治疗方法。关键在于，即使在看似无害的损伤病例中，也必须在初始阶段尽早考虑功能结构的受累情况。
