Schon L C, Marks R M
Department of Orthopaedic Surgery, Union Memorial Hospital, Baltimore, Maryland, USA.
Orthop Clin North Am. 1995 Apr;26(2):375-92.
Appropriate management for the diabetic patient with a fracture or sprain depends on recognition of "at-risk" factors. For patients with stable, minimally displaced injuries, conservative modalities (prolonged immobilization and non-weight-bearing) are sufficient. For patients with unstable or displaced fracture-dislocations, and whose general condition does not contraindicate surgery, open reduction and internal fixation, at times combined with external fixation, is recommended. Initial aggressive management can avoid or minimize the disastrous sequelae of a destructive neuroarthropathic process and can effect a biomechanically sound plantigrade, braceable, and shoeable lower extremity.
对患有骨折或扭伤的糖尿病患者进行适当的治疗取决于对“风险”因素的识别。对于损伤稳定、移位极小的患者，保守治疗方法（长期固定和不负重）就足够了。对于骨折脱位不稳定或有移位且全身状况不 contraindicate 手术的患者，建议进行切开复位内固定，有时结合外固定。早期积极治疗可避免或最小化破坏性神经关节病过程的灾难性后果，并可使下肢在生物力学上达到良好的足底着地、可使用支具和鞋子的状态。 （注：原文中“does not contraindicate”表述不太准确，推测可能是“does not contraindicate surgery”即“不 contraindicate 手术”，“contraindicate”意为“禁忌”，这里不太明确确切意思，暂按此翻译。）
