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开放性骨折的现代处理,显著提高了挽教肢体的潜力。但由于缺少适当的客观参数,常使许多病例延期截肢。本文研究了严重胫骨开放性骨折,初期截肢及延期截肢的医疗效果和经济影响。 1980至1986年间,共处理了263名Ⅱ级胫骨开放性骨折患者。有43人最终做了截肢,其中男38名,女5名,平均31岁。对所有患者均考虑进行挽救肢体的手术,包括清创术、筋膜切开术、血管再通术及固定术。清创时根据颜色、坚韧性、出血和收缩性来确定肌肉活性。如果大量肌肉失去活性,则行截肢。14(32.6％)人进行了初期截肢术。他们平均住院22.3天,平均接受了1.6次有关患肢的手术,平均住院花费28964
The modern treatment of open fractures significantly increases the potential for limb healing. However, many cases are often postponed due to the lack of appropriate objective parameters. This article studies the medical and economic impact of severe tibial open fractures, initial amputations and delayed amputations. Between 1980 and 1986, 263 patients with grade II tibial open fractures were treated. Of the 43 people who eventually made amputations, 38 were males and 5 were females, with an average of 31 years. All patients were considered for salvage surgery, including debridement, fasciotomy, revascularization and fixation. Debridement is based on color, tenacity, bleeding and contractility to determine muscle activity. Amputation is performed if a lot of muscles lose their activity. 14 (32.6%) had initial amputation. They had an average hospitalization of 22.3 days and received an average of 1.6 limb-related surgeries, with an average hospitalization cost of 28,964