Orthopaedic and Trauma Department, Hospital Santa Maria delle Croci, Ravenna, Italy.
Orthopaedic and Trauma Department, University Vita-Salute San Raffaele, Milan, Italy.
Acta Biomed. 2021 Jul 26;92(S3):e2021018. doi: 10.23750/abm.v92iS3.11736.
Open tibial fractures are mostly the result of high-energy traumas and often involve severe injuries with extensive bone and soft tissue loss, damage of muscles and neurovascular structures. Over recent- years, - the growth of Ortho-Plastic teams, as a well-coordinated bone, joint and soft tissue treatment, contributed to change the approach to these fractures and to achieve higher successful results in lower limb salvage. Unfortunately, many hospitals cannot benefit of a combined team in emergency, and the orthopedic surgeon is forced to manage personally these kinds of traumas.
We retrospectively reviewed all the open tibial fractures treated at our Orthopaedic Department over the last 10 years, in order to assess the treatments performed (one-stage fixation with Intramedullary Nailing or Open Reduction Internal Fixation - ORIF, versus two/multiple-stage fixation with temporary External Fixation followed by nailing or ORIF) and the differences in the outcome between the different methods.
Based on our experience and review of the literature, the purpose of this paper is to define what cases can be managed by a single-stage orthopaedic approach, and when the orthopaedist should lay down his arms in favor of other specialties.
开放性胫骨骨折主要是高能创伤的结果，常伴有严重的骨和软组织损伤、肌肉和神经血管结构损伤。近年来，矫形外科研团队的发展，作为一种协调良好的骨、关节和软组织治疗方法，有助于改变对这些骨折的治疗方法，并在下肢保肢方面取得更高的成功率。不幸的是，许多医院在急救时无法受益于联合团队，骨科医生被迫亲自处理这些创伤。
我们回顾性分析了过去 10 年来在我们骨科治疗的所有开放性胫骨骨折，以评估所采用的治疗方法（一期髓内钉固定或切开复位内固定与二期/多期临时外固定架固定后钉或 ORIF）以及不同方法之间结果的差异。
基于我们的经验和文献复习，本文的目的是确定哪些病例可以通过单一阶段的骨科方法治疗，以及何时骨科医生应该放下他的手臂，转而寻求其他专业的帮助。
