Pierrie Sarah N, Beltran Michael J
Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, Cincinnati, OH.
OTA Int. 2023 Jul 11;6(4 Suppl):e245. doi: 10.1097/OI9.0000000000000245. eCollection 2023 Jul.
Reestablishing an intact, healthy soft tissue envelope is a critical step in managing lower extremity injuries, particularly high-grade open tibia fractures. Acute shortening and angulation can be used independently or together to address complex soft tissue injuries, particularly when bone loss is present. These techniques facilitate management of difficult wounds and can be combined with local soft tissue rearrangement or pedicled flaps as needed, avoiding the need for free tissue transfer. After angular deformity correction, adjacent bone loss can be addressed with bone grafting or distraction histogenesis. This article discusses the indications for, surgical technique for, and limitations of acute shortening and angulation for management of open lower extremity fractures.
重建完整、健康的软组织包膜是处理下肢损伤的关键步骤，尤其是严重的开放性胫骨骨折。急性短缩和成角可单独或联合使用，以处理复杂的软组织损伤，特别是在存在骨缺损的情况下。这些技术有助于处理难愈伤口，并可根据需要与局部软组织重排或带蒂皮瓣联合使用，避免了游离组织移植的需要。在矫正成角畸形后，相邻的骨缺损可通过植骨或牵张组织再生来处理。本文讨论了急性短缩和成角在处理开放性下肢骨折中的适应证、手术技术及局限性。
