Tscherne H
Langenbecks Arch Chir. 1986;369:539-42. doi: 10.1007/BF01274428.
The complex injury of the foot requires immediate decisions. At first the question of vital danger and amputation should be ruled out. The criteria for the conservation of the extremity will be shown. For the most severely injured, primary amputation is indicated, since all attempts of preservation in this group hardly survived. The two-step amputation is recommended: i.e. "Guillotine"-amputation in the acute phase and muscle plastic stump formation in the regeneration phase. Important principles of treatment are: immediate anatomic reduction and retention of fractures and unstable joints, open wound treatment, delayed closure and reconstructive plastic intervention. A planned "second-look"-operation is obligatory.
足部的复杂损伤需要立即做出决策。首先应排除生命危险和截肢问题。将展示保肢的标准。对于损伤最严重的患者，建议进行一期截肢，因为该组中所有的保肢尝试几乎都未能成功。推荐采用两步截肢法，即在急性期进行“断头台式”截肢，在再生期进行肌肉整形残端成形术。重要的治疗原则包括：立即进行解剖复位并固定骨折和不稳定关节、开放伤口处理、延迟缝合以及重建整形干预。必须进行计划性的“二次探查”手术。
