Yanagisawa Yohei, Watanabe Yu, Yamazaki Masashi
Department of Orthopaedic Surgery, University of Tsukuba, Japan.
J Rural Med. 2020 Oct;15(4):221-224. doi: 10.2185/jrm.2020-019. Epub 2020 Oct 1.
As the average life expectancy is increasing, the number of patients aged >100 years who have fragility fractures will increase in the future. In female patients, the incidence of open fractures increases with age. We present the case of a 102-year-old woman with open tibial and fibular diaphyseal fractures (Gustilo-Anderson classification type IIIb) treated with temporary external fixation, advancement flap, and negative pressure wound therapy in the first-stage surgery and treatment, and open reduction and internal fixation with skin grafting in the second-stage surgery. Open wound and bone healing were attained. Surgery should not be denied on the basis of age alone. Medical evaluation should focus on identifying risk factors, assessing risk in detail, optimizing status, predicting complications, and making the appropriate surgical plan for the patient status. Moreover, in the present case, meticulous postoperative management was the main reason for the successful surgical treatment.
随着平均预期寿命的增加,未来年龄大于100岁且发生脆性骨折的患者数量将会增加。在女性患者中,开放性骨折的发生率随年龄增长而增加。我们报告了一例102岁女性患者,其胫腓骨干开放性骨折(Gustilo-Anderson分类IIIb型),一期手术采用临时外固定、推进皮瓣和负压伤口治疗,二期手术采用切开复位内固定并植皮。伤口愈合且骨愈合良好。不应仅基于年龄而拒绝手术。医学评估应着重于识别风险因素、详细评估风险、优化状态、预测并发症以及根据患者状况制定合适的手术方案。此外,在本病例中,细致的术后管理是手术治疗成功的主要原因。