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[多发伤中股骨骨折的手术治疗策略]

[The strategy for the surgical treatment of femoral fractures in polytrauma].

作者信息

Shapkin Yu G, Seliverstov P A

出版信息

Klin Med (Mosk). 2016;94(5):346-52.

Abstract

The review describes peculiarities of the choice of time and methods of osteosynthesis offemur fractures of different localization in patients with multiple injuries in accordance with modern concepts of treatment of severe multiple and associated lesions. Analysis of domestic and foreign literature shows that earlyfixation of the femur in case of polytrauma can reduce the mortality rate associated with complications and improve the functional outcome. Terms of osteosynthesis of the femur in polytrauma should be chosen taking into account the severity of the injury, the patient's condition, and the period of traumatic disease. The procedure of osteosynthesis must not be a threat to the clinical condition. The choice of the method for fixation of the femur depends of fracture type and location, the presence of fractures in the adjacent and remote segments. The minimally invasive techniques of osteosynthesis of the femur and staged surgical treatment of the victims in an unstable state should be chosen for the treatment of multiple injury in accordance with the concept of «Damage Control Orthopedics».

摘要

这篇综述根据严重多发伤和合并伤的现代治疗理念,描述了多发伤患者不同部位股骨骨折骨固定时间和方法的特点。国内外文献分析表明,多发伤时早期固定股骨可降低与并发症相关的死亡率并改善功能预后。选择多发伤时股骨的骨固定时机应考虑损伤的严重程度、患者的状况以及创伤病程。骨固定操作不得对临床状况构成威胁。股骨固定方法的选择取决于骨折类型和部位、相邻及远处节段是否存在骨折。应根据“损伤控制骨科”理念,选择股骨微创骨固定技术和对不稳定状态受害者进行分期手术治疗多发伤。

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