Plotnikovs Konstantins, Movcans Jevgenijs, Solomin Leonid
Department of Orthopedic Surgeon, Traumatology and Orthopedics, Riga East University Hospital, Rīga Stradiņš University, Riga, Latvia.
Department of Traumatology and Orthopaedics, Riga East Clinical University Hospital, Riga, Latvia.
Strategies Trauma Limb Reconstr. 2022 Jan-Apr;17(1):44-54. doi: 10.5005/jp-journals-10080-1551.
The presence of massive soft tissue loss in open tibial fractures is a challenging problem. Acute limb shortening is an alternative solution in situations where the use of flaps is limited.
A review was conducted following the Preferred Reported Items for Systematic Reviews and Meta-analyses checklist (PRISMA) guidelines. A complete search of PubMed, EMBASE and MEDLINE was undertaken. Twenty-four articles related to closure of soft tissue defects through acute limb shortening were identified and included in this review.
All report on restoration of limb function without or with minimal residual shortening. The authors note a decrease in the need for microsurgery. The external fixation devices used for deformity correction after closure of the soft tissue defect by acute shortening, angulation and rotation were the Ilizarov apparatus and circular fixator hexapods mainly.
Acute shortening is an alternative to microsurgical techniques. A ring external fixator is useful for restoring limb alignment after closing the soft tissue defect through creating a temporary deformity. The use of circular fixator hexapods can enable accurate correction of complex multicomponent deformities without the need to reassembly of individual correction units.
Plotnikovs K, Movcans J, Solomin L. Acute Shortening for Open Tibial Fractures with Bone and Soft Tissue Defects: Systematic Review of Literature. Strategies Trauma Limb Reconstr 2022;17(1):44-54.
开放性胫骨骨折伴有大量软组织缺损是一个具有挑战性的问题。在皮瓣使用受限的情况下，急性肢体短缩是一种替代解决方案。
按照系统评价和Meta分析的首选报告项目清单（PRISMA）指南进行综述。对PubMed、EMBASE和MEDLINE进行了全面检索。共识别出24篇与通过急性肢体短缩闭合软组织缺损相关的文章，并纳入本综述。
所有研究均报告了肢体功能得以恢复，残留短缩极少或无残留短缩。作者指出显微外科手术的需求有所减少。在通过急性短缩、成角和旋转闭合软组织缺损后用于矫正畸形的外固定装置主要是伊利扎罗夫器械和环形固定器六足架。
急性短缩是显微外科技术的一种替代方法。环形外固定器有助于在通过制造临时畸形闭合软组织缺损后恢复肢体对线。使用环形固定器六足架能够精确矫正复杂的多成分畸形，而无需重新组装各个矫正单元。
Plotnikovs K, Movcans J, Solomin L. Acute Shortening for Open Tibial Fractures with Bone and Soft Tissue Defects: Systematic Review of Literature. Strategies Trauma Limb Reconstr 2022;17(1):44-54.
