多发伤儿童骨科损伤的管理

Lahoti Om, Arya Anand

Department of Trauma and Orthopaedics, King's College Hospital, Denmark Hill, London, UK.

Indian J Orthop. 2018 Sep-Oct;52(5):454-461. doi: 10.4103/ortho.IJOrtho_359_17.

Multiply injured child is a unique challenge to the medical communities worldwide. It is a leading cause of preventable mortality and morbidity in children. Common skeletal injuries include closed or open fractures of tibia and femur and pelvic injuries. Initial management focuses on saving life and then saving limb as per pediatric advanced life support and advanced trauma life support. Orthopedic management of open fracture includes splinting the limb, administration of prophylactic antibiotic, and surgical debridement of the wound when safe. However, gross contamination, compartment syndrome, and vascular injuries demand urgent attention.

多发伤儿童对全球医学界来说是一项独特的挑战。它是儿童可预防死亡和发病的主要原因。常见的骨骼损伤包括胫骨和股骨的闭合性或开放性骨折以及骨盆损伤。初始治疗重点是按照儿科高级生命支持和高级创伤生命支持原则先挽救生命，然后再挽救肢体。开放性骨折的骨科处理包括固定肢体、预防性使用抗生素，以及在安全的情况下对伤口进行外科清创。然而，严重污染、骨筋膜室综合征和血管损伤需要紧急处理。