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开放性骨折指骨折断端或骨折血肿与外界环境相通的骨折,是儿童较严重的高能量损伤,主要由交通事故及高空坠落所致。治疗原则包括及时清创与抗生素的使用、骨折复位与固定及早期软组织覆盖等。骨折复位与固定是治疗儿童开放性骨折的中心环节,临床常用的固定方法有:医用夹板、牵引、克氏针、接骨板、髓内针髓内固定及外固定支架等。对于儿童开放性骨折治疗方法的选择一直存在争议,选择外固定或内固定,常为临床医师遇到儿童开放性骨折时的两难选择。本文对儿童不同部位的开放性骨折固定方式的选择进行文献回顾。
Open fractures Finger fracture or fracture hematoma and the external environment connected fractures, children are more serious high-energy damage, mainly caused by traffic accidents and altitude crashes. Treatment principles include timely debridement and antibiotic use, fracture reduction and fixation, and early soft tissue coverage. Fracture reduction and fixation is the central part of the treatment of open fractures in children. The commonly used methods of fixation are: medical splint, traction, Kirschner wire, bone plate, intramedullary nail and external fixation. The choice of treatment for open fractures of children has been controversial, the choice of external fixation or fixation, often for clinicians encountered dilemma in children with open fractures. This article reviews the literature on the selection of open fractures in different parts of children.