Lemaire R
Acta Chir Belg. 1982 Sep-Oct;82(5):449-56.
A critical study is made of the management of fractures associated with major vascular injuries. The pros and cons of surgical and conservative management are analyzed; it is emphasized that internal fixation, although largely used in civilian practice, is by no means necessary for successful vascular repair. The latter must be given prevalence in every instance, and an aggressive approach to the skeletal lesion is justified only in selected cases where it will not jeopardize the results of vascular repair. The therapeutic approach is analyzed step by step: selection of external or internal fixation, chronological sequence of procedures, selection of a mode of internal fixation and of a surgical approach. The different techniques of internal fixation available for upper and lower limb fractures are considered. It is concluded that the method of management of fractures associated with vascular injuries remains controversial and must be selected in every instance by a team discussion taking into account the various parameters related to both skeletal and vascular problems.
对伴有主要血管损伤的骨折处理进行了批判性研究。分析了手术治疗和保守治疗的利弊；强调尽管内固定在普通临床实践中广泛应用，但对于成功的血管修复而言绝非必要。在每种情况下都必须优先进行血管修复，只有在特定病例中，积极处理骨骼损伤且不会危及血管修复结果时才是合理的。逐步分析了治疗方法：外固定或内固定的选择、手术步骤的时间顺序、内固定方式和手术入路的选择。考虑了可用于上肢和下肢骨折的不同内固定技术。得出结论，伴有血管损伤的骨折处理方法仍存在争议，必须在每种情况下通过团队讨论，并考虑与骨骼和血管问题相关的各种参数来选择。
