Mathieu L, Grosset A, Bertani A, Potier L, Murison J C, Niang C D, Rigal S
Service de chirurgie orthopédique, traumatologie et chirurgie réparatrice des membres, Hôpital d'instruction des armées Percy, Clamart, France, Chaire de chirurgie appliquée aux armées, École du Val-de-Grâce, Paris, France.
Service de chirurgie orthopédique, traumatologie et chirurgie réparatrice des membres, Hôpital d'instruction des armées Percy, Clamart, France.
Med Sante Trop. 2018 May 1;28(2):133-139. doi: 10.1684/mst.2018.0775.
In developing countries, road traffic accidents result in many cases of open trauma, especially fractures, with the tibia area at particular risk in motorcycle crashes. Despite a high prevalence of severe leg trauma with multi-tissue injuries, few studies have focused on the challenge of their reconstruction in these limited-resource settings. The first part of this review presents the surgical strategy. Limitations and principles of initial limb salvage are detailed. Orthopedic procedures for early damage control, based on debridement and temporary bone stabilization, are often required. The priority is to shorten the time to initial surgical management to avoid infection, which jeopardizes reconstruction.
在发展中国家,道路交通事故导致许多开放性创伤病例,尤其是骨折,在摩托车碰撞事故中胫骨部位面临特别的风险。尽管严重腿部创伤合并多组织损伤的发生率很高,但在这些资源有限的环境中,很少有研究关注其重建面临的挑战。本综述的第一部分介绍了手术策略。详细阐述了初始肢体挽救的局限性和原则。基于清创和临时骨稳定的早期损伤控制的骨科手术往往是必需的。首要任务是缩短至初始手术治疗的时间,以避免感染,因为感染会危及重建。