开放性胫骨骨折：概述
Open tibial fractures: An overview.
作者信息
Nicolaides Marios, Pafitanis Georgios, Vris Alexandros
机构信息
Division of Orthopaedics, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Group for Academic Plastic Surgery, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
出版信息
J Clin Orthop Trauma. 2021 Jun 24;20:101483. doi: 10.1016/j.jcot.2021.101483. eCollection 2021 Sep.
Open tibial fractures are complex injuries with multifactorial outcomes and variable prognosis. The close proximity of the tibia to the skin makes it prone to extensive soft tissue damage and subsequent detrimental complications, such as infection and non-union. Thus, they were historically associated with high rates of amputation, sepsis, or even death. The advancement of surgical instruments and techniques, along the emergence of evidence-based guidance, have resulted in a significant reduction in complications. Peculiarly though, modern management strategies have a strong foundation in practices described in the ancient times. Nevertheless, post-operative complications are still a challenge in the management of open tibial fractures. Efforts are actively being made to refine the surgical approaches used, while noteworthy is the emergence of the Orthoplastic approach. The aim of this review is to summarise and discuss the historical perspective of the management of open tibial fractures, their epidemiology and classification, up-to-date principles of surgical management and outcomes following injury.
开放性胫骨骨折是一种复杂的损伤，其结果受多种因素影响，预后也各不相同。胫骨与皮肤距离较近，这使其容易受到广泛的软组织损伤以及随后出现的诸如感染和骨不连等有害并发症。因此，在历史上，开放性胫骨骨折与高截肢率、败血症甚至死亡相关。随着循证指南的出现，手术器械和技术的进步已使并发症显著减少。然而，奇怪的是，现代治疗策略有着深厚的古代所述实践基础。尽管如此，术后并发症仍是开放性胫骨骨折治疗中的一项挑战。目前正在积极努力改进所采用的手术方法，值得注意的是整形骨科手术方法的出现。本综述的目的是总结和讨论开放性胫骨骨折治疗的历史观点、其流行病学和分类、最新的手术治疗原则以及损伤后的治疗结果。
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