Carr J B
Division of Orthopedic Surgery, Medical College of Virginia Hospitals, Richmond.
Orthop Clin North Am. 1994 Oct;25(4):613-24.
Treatment of complex periarticular fractures of the lower extremity is guided by the principle of soft-tissue preservation. A skin incision through the subcutaneous tissue to incise the periosteum, followed by judicious application of implants will incur the least amount of iatrogenic damage. The concept of "sufficient stability" can replace the need for "rigid fixation" in many instances. Operative treatment should be considered a complementary extension to the well-founded principles of nonoperative treatment rather than the antithesis. In the final analysis, the approach of a biologist or gardener will yield better results than a strictly mechanical or saw bone laboratory approach.
下肢复杂关节周围骨折的治疗以软组织保护原则为指导。通过皮下组织做皮肤切口以切开骨膜，然后谨慎应用植入物，将产生最少的医源性损伤。在许多情况下，“充分稳定”的概念可以取代“坚强固定”的需求。手术治疗应被视为对非手术治疗既定原则的补充扩展，而非对立面。归根结底，生物学家或园艺师的方法会比严格机械或锯骨实验室方法产生更好的效果。
