Nicholas R M, Boston V E, Small J, Kerr Graham H
Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland.
J Bone Joint Surg Br. 1995 May;77(3):439-41.
Combined bony and vascular injuries present challenging problems to orthopaedic and vascular surgeons. The use of temporary intraluminal vascular shunts produces significant reductions in ischaemia time and allows fracture stabilisation to be performed before definitive, delicate vascular repair. We report our management of a five-week-old infant who sustained a comminuted fracture of the femur with arterial and venous injuries in a shooting incident. Paediatric nasogastric feeding tubes were used as temporary vascular shunts to re-establish the distal circulation. Stabilisation of the fracture was then followed by vascular reconstruction and soft-tissue surgery, with a good result. We emphasise the need for skills from several surgical disciplines in the management of complex combined injuries.
合并存在的骨与血管损伤给骨科和血管外科医生带来了具有挑战性的问题。使用临时性腔内血管分流术可显著缩短缺血时间，并能在进行精细的确定性血管修复之前先对骨折进行固定。我们报告了一名5周大婴儿的治疗情况，该婴儿在一次枪击事件中股骨发生粉碎性骨折并伴有动静脉损伤。使用小儿鼻胃饲管作为临时性血管分流装置来重建远端循环。骨折固定后接着进行血管重建和软组织手术，结果良好。我们强调在处理复杂的合并损伤时需要多个外科专业的技术。
