首页 中华创伤骨科杂志 2019年21卷11期 中国开放性骨折诊断与治疗指南(2019版)
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ENGLISH ABSTRACT
中国开放性骨折诊断与治疗指南(2019版)
中华医学会骨科学分会创伤骨科学组 
中华医学会骨科学分会外固定与肢体重建学组
中国医师协会创伤外科医师分会创伤感染专业委员会
中国医师协会骨科医师分会创伤专家工作委员会
作者及单位信息
·
DOI： 10.3760/cma.j.issn.1671-7600.2019.11.001
Guidelines on diagnosis and treatment of open fractures in China(2019)
Traumatic Orthopedics Group, Society of Orthopedics, Chinese Medical Association
Group of External Fixation and Limb Reconstruction, Society of Orthopedics, Chinese Medical Association
Professional Committee of Traumatic Infection, Society of Traumatic Surgeons, Association of Chinese Doctors
Trauma Experts Working Committee, Society of Orthopaedists, Association of Chinese Doctors
Authors Info & Affiliations
Traumatic Orthopedics Group, Society of Orthopedics, Chinese Medical Association
Group of External Fixation and Limb Reconstruction, Society of Orthopedics, Chinese Medical Association
Professional Committee of Traumatic Infection, Society of Traumatic Surgeons, Association of Chinese Doctors
Trauma Experts Working Committee, Society of Orthopaedists, Association of Chinese Doctors
·
DOI： 10.3760/cma.j.issn.1671-7600.2019.11.001
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摘要
随着社会经济高速发展，各类创伤因素导致的肢体开放性骨折日趋增多，开放性骨折患者伤情复杂多变，规范处理决定良好预后。目前我国缺乏开放性骨折相关的诊疗共识，为提高创伤救治水平，规范开放性骨折的诊断和治疗流程，降低伤残率及病死率，参考国内外资料，结合我国实际情况，由中华医学会骨科学分会创伤骨科学组、中华医学会骨科学分会外固定与肢体重建学组、中国医师协会创伤外科医师分会创伤感染专业委员会、中国医师协会骨科医师分会创伤专家工作委员会共同起草制定本指南。
引用本文
中华医学会骨科学分会创伤骨科学组,中华医学会骨科学分会外固定与肢体重建学组,中国医师协会创伤外科医师分会创伤感染专业委员会,等. 中国开放性骨折诊断与治疗指南(2019版)[J]. 中华创伤骨科杂志,2019,21(11)：921-928.
DOI:10.3760/cma.j.issn.1671-7600.2019.11.001PERMISSIONS
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随着社会经济高速发展，各类创伤因素导致的肢体开放性骨折日趋增多，开放性骨折患者伤情复杂多变，规范处理决定良好预后。目前我国缺乏开放性骨折相关的诊疗共识，为提高创伤救治水平，规范开放性骨折的诊断和治疗流程，降低伤残率及病死率，参考国内外资料，结合我国实际情况，由中华医学会骨科学分会创伤骨科学组、中华医学会骨科学分会外固定与肢体重建学组、中国医师协会创伤外科医师分会创伤感染专业委员会、中国医师协会骨科医师分会创伤专家工作委员会共同起草制定本指南。
本指南从10个方面阐述中国开放性骨折治疗：开放性骨折概述、开放性骨折分型、急诊处理、抗生素使用、清创原则、骨折稳定技术、软组织重建、筋膜间室综合征、一期截肢和损伤控制。
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参考文献
[1]
Gustilo RB , Mendoza RM , Williams DN . Problems in the management of type Ⅲ (severe) open fractures: a new classification of type Ⅲ open fractures[J]. J Trauma, 1984,24(8):742-746. DOI:
10.1097/00005373-198408000-00009
.
[2]
Gustilo RB . Interobserver agreement in the classification of open fractures of the tibia.The results of a survey of two hundred and forty-five orthopaedic surgeons[J]. J Bone Joint Surg Am, 1995,77(8):1291-1292. DOI:
10.2106/00004623-199508000-00024
.
[3]
Johansen K , Daines M , Howey T ,et al. Objective criteria accurately predict amputation following lower extremity trauma[J]. J Trauma, 1990,30(5):568-572, 572-573. DOI:
10.1097/00005373-199005000-00007
.
[4]
Jedlicka N , Summers NJ , Murdoch MM . Overview of concepts and treatments in open fractures[J]. Clin Podiatr Med Surg, 2012,29(2):279-290. DOI:
10.1016/j.cpm.2012.01.006
.
[5]
Gustilo RB , Anderson JT . Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses[J]. J Bone Joint Surg Am, 1976,58(4):453-458. DOI:
10.2106/00004623-197658040-00004
.
[6]
Gustilo RB , Anderson JT . JSBS classics.Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones.Retrospective and prospective analyses[J]. J Bone Joint Surg Am, 2002,84(4):682. DOI:
10.2106/00004623-200204000-00029
.
[7]
Lee C , Porter KM . Prehospital management of lower limb fractures[J]. Emerg Med J, 2005,22(9):660-663. DOI:
10.1136/emj.2005.024489
.
[8]
Rossaint R , Bouillon B , Cerny V ,et al. Management of bleeding following major trauma: an updated European guideline[J]. Crit Care, 2010,14(2):R52. DOI:
10.1186/cc8943
.
[9]
Kragh JF , O Neill ML , Beebe DF ,et al. Survey of the indications for use of emergency tourniquets[J]. J Spec Oper Med, 2011,11(1):30-38.
[10]
Beekley AC , Sebesta JA , Blackbourne LH ,et al. Prehospital tourniquet use in Operation Iraqi Freedom: effect on hemorrhage control and outcomes[J]. J Trauma, 2008,64(2Suppl):S28-S37, S37. DOI:
10.1097/TA.0b013e318160937e
.
[11]
Jagoda AS , Campbell M , Karas SJ ,et al. Clinical Policy for Procedural Sedation and Analgesia in the Emergency Department[J]. Ann Emerg Med, 1998,31(5):663-677. DOI:
10.1016/S0196-0644(98)70216-1
.
[12]
Godwin SA , Caro DA , Wolf SJ ,et al. Clinical policy: procedural sedation and analgesia in the emergency department[J]. Ann Emerg Med, 2005,45(2):177-196. DOI:
10.1016/j.annemergmed.2004.11.002
.
[13]
Schauer SG , Mora AG , Maddry JK ,et al. Multicenter, prospective study of prehospital administration of analgesia in the U.S. Combat Theater of Afghanistan[J]. Prehosp Emerg Care, 2017,21(6):744-749. DOI:
10.1080/10903127.2017.1335814
.
[14]
Porter K . Ketamine in prehospital care[J]. Emerg Med J, 2004,21(3):351-354. DOI:
10.1136/emj.2003.010843
.
[15]
O＇Connor RE , Sama A , Burton JH ,et al. Procedural sedation and analgesia in the emergency department: recommendations for physician credentialing, privileging, and practice[J]. Ann Emerg Med, 2011,58(4):365-370. DOI:
10.1016/j.annemergmed.2011.06.020
.
[16]
Vivien B , Adnet F , Bounes V ,et al. Sedation and analgesia in emergency structure.Reactualization 2010 of the Conference of Experts of Sfar of 1999[J]. Ann Fr Anesth Reanim, 2012,31(4):391-404. DOI:
10.1016/j.annfar.2012.02.006
.
[17]
Godwin SA , Burton JH , Gerardo CJ ,et al. Clinical policy: procedural sedation and analgesia in the emergency department[J]. Ann Emerg Med, 2014,63(2):247-258. DOI:
10.1016/j.annemergmed.2013.10.015
.
[18]
Miner JR , Gray RO , Bahr J ,et al. Randomized clinical trial of propofol versus ketamine for procedural sedation in the emergency department[J]. Acad Emerg Med, 2010,17(6):604-611. DOI:
10.1111/j.1553-2712.2010.00776.x
.
[19]
Phillips W , Anderson A , Rosengreen M ,et al. Propofol versus propofol/ketamine for brief painful procedures in the emergency department: clinical and bispectral index scale comparison[J]. J Pain Palliat Care Pharmacother, 2010,24(4):349-355. DOI:
10.3109/15360288.2010.506503
.
[20]
Ruth WJ , Burton JH , Bock AJ . Intravenous etomidate for procedural sedation in emergency department patients[J]. Acad Emerg Med, 2001,8(1):13-18. DOI:
10.1111/j.1553-2712.2001.tb00539.x
.
[21]
Dochez E , van Geffen GJ , Bruhn J ,et al. Prehospital administered fascia iliaca compartment block by emergency medical service nurses, a feasibility study[J]. Scand J Trauma Resusc Emerg Med, 2014,22:38. DOI:
10.1186/1757-7241-22-38
.
[22]
McRae PJ , Bendall JC , Madigan V ,et al. Paramedic-performed fascia iliaca compartment block for femoral fractures: a controlled trial[J]. J Emerg Med, 2015,48(5):581-589. DOI:
10.1016/j.jemermed.2014.12.016
.
[23]
Quinn RH , Wedmore I , Johnson EL ,et al. Wilderness Medical Society practice guidelines for basic wound management in the austere environment: 2014 update[J]. Wilderness Environ Med, 2014,25(4Suppl):S118-S133. DOI:
10.1016/j.wem.2014.08.015
.
[24]
Ozdemir G , Yilmaz B , Komur B ,et al. Treatment preferences in Turkey for open fracture of the tibial diaphysis[J]. Acta Orthop Traumatol Turc, 2017,51(2):133-137. DOI:
10.1016/j.aott.2016.12.010
.
[25]
中国医师协会急诊医师分会，中国人民解放军急救医学专业委员会，北京急诊医学学会,等. 成人破伤风急诊预防及诊疗专家共识[J]. 临床急诊杂志, 2018,19(12):801-811. DOI:
10.13201/j.issn.1009-5918.2018.12.001
.
Society of Emergency Physicians, Association of Chinese Doctors;Professional Committee of Emergency Medicine, The Chinese People's Liberation Army;Beijing Society of Emergency Medicine;et al. Experts consensus on emergency prevention, diagnosis and treatment of adult tetanus[J]. J Clin Emerg, 2018,19(12):801-811. DOI:
10.13201/j.issn.1009-5918.2018.12.001
.
[26]
Patzakis MJ , Wilkins J , Moore TM . Considerations in reducing the infection rate in open tibial fractures[J]. Clin Orthop Relat Res, 1983(178):36-41. DOI:
10.1097/00003086-198309000-00006
.
[27]
Patzakis MJ , Wilkins J . Factors influencing infection rate in open fracture wounds[J]. Clin Orthop Relat Res, 1989(243):36-40. DOI:
10.1097/00003086-198906000-00006
.
[28]
Iorio ML , Harper CM , Rozental TD . Open distal radius fractures: timing and strategies for surgical management[J]. Hand Clin, 2018,34(1):33-40. DOI:
10.1016/j.hcl.2017.09.004
.
[29]
Ondari JN , Masika MM , Ombachi RB ,et al. Unblinded randomized control trial on prophylactic antibiotic use in gustilo Ⅱ open tibia fractures at Kenyatta National Hospital, Kenya[J]. Injury, 2016,47(10):2288-2293. DOI:
10.1016/j.injury.2016.07.014
.
[30]
Saveli CC , Morgan SJ , Belknap RW ,et al. Prophylactic antibiotics in open fractures: a pilot randomized clinical safety study[J]. J Orthop Trauma, 2013,27(10):552-557. DOI:
10.1097/BOT.0b013e31828d92ee
.
[31]
Rodriguez L , Jung HS , Goulet JA ,et al. Evidence-based protocol for prophylactic antibiotics in open fractures: improved antibiotic stewardship with no increase in infection rates[J]. J Trauma Acute Care Surg, 2014,77(3):400-407, 407-408, 524. DOI:
10.1097/TA.0000000000000398
.
[32]
Hauser CJ , Adams CJ , Eachempati SR . Surgical Infection Society guideline: prophylactic antibiotic use in open fractures: an evidence-based guideline[J]. Surg Infect (Larchmt), 2006,7(4):379-405. DOI:
10.1089/sur.2006.7.379
.
[33]
Dunkel N , Pittet D , Tovmirzaeva L ,et al. Short duration of antibiotic prophylaxis in open fractures does not enhance risk of subsequent infection[J]. Bone Joint J, 2013,95-B(6):831-837. DOI:
10.1302/0301-620X.95B6.30114
.
[34]
Anderson A , Miller AD , Brandon BP . Antimicrobial prophylaxis in open lower extremity fractures[J]. Open Access Emerg Med, 2011,3:7-11. DOI:
10.2147/OAEM.S11862
.
[35]
Hoff WS , Bonadies JA , Cachecho R ,et al. East Practice Management Guidelines Work Group: update to practice management guidelines for prophylactic antibiotic use in open fractures[J]. J Trauma, 2011,70(3):751-754. DOI:
10.1097/TA.0b013e31820930e5
.
[36]
Zalavras CG . Prevention of infection in open fractures[J]. Infect Dis Clin North Am, 2017,31(2):339-352. DOI:
10.1016/j.idc.2017.01.005
.
[37]
Carver DC , Kuehn SB , Weinlein JC . Role of systemic and local antibiotics in the treatment of open fractures[J]. Orthop Clin North Am, 2017,48(2):137-153. DOI:
10.1016/j.ocl.2016.12.005
.
[38]
Harley BJ , Beaupre LA , Jones CA ,et al. The effect of time to definitive treatment on the rate of nonunion and infection in open fractures[J]. J Orthop Trauma, 2002,16(7):484-490. DOI:
10.1097/00005131-200208000-00006
.
[39]
Ashford RU , Mehta JA , Cripps R . Delayed presentation is no barrier to satisfactory outcome in the management of open tibial fractures[J]. Injury, 2004,35(4):411-416. DOI:
10.1016/S0020-1383(03)00236-5
.
[40]
Reuss BL , Cole JD . Effect of delayed treatment on open tibial shaft fractures[J]. Am J Orthop (Belle Mead NJ), 2007,36(4):215-220.
[41]
Crowley DJ , Kanakaris NK , Giannoudis PV . Irrigation of the wounds in open fractures[J]. J Bone Joint Surg Br, 2007,89(5):580-585. DOI:
10.1302/0301-620X.89B5.19286
.
[42]
Srour M , Inaba K , Okoye O ,et al. Prospective evaluation of treatment of open fractures: effect of time to irrigation and debridement[J]. JAMA Surg, 2015,150(4):332-336. DOI:
10.1001/jamasurg.2014.2022
.
[43]
Weber D , Dulai SK , Bergman J ,et al. Time to initial operative treatment following open fracture does not impact development of deep infection: a prospective cohort study of 736 subjects[J]. J Orthop Trauma, 2014,28(11):613-619. DOI:
10.1097/BOT.0000000000000197
.
[44]
Bhandari M , Jeray KJ , Petrisor BA ,et al. A trial of wound irrigation in the initial management of open fracture wounds[J]. N Engl J Med, 2015,373(27):2629-2641. DOI:
10.1056/NEJMoa1508502
.
[45]
Anglen JO . Comparison of soap and antibiotic solutions for irrigation of lower-limb open fracture wounds. A prospective, randomized study[J]. J Bone Joint Surg Am, 2005,87(7):1415-1422. DOI:
10.2106/JBJS.D.02615
.
[46]
Sprague S , Petrisor B , Jeray K ,et al. Wound irrigation does not affect health-related quality of life after open fractures: results of a randomized controlled trial[J]. Bone Joint J, 2018,100-B(1):88-94. DOI:
10.1302/0301-620X.100B1.BJJ-2017-0955.R1
.
[47]
Pape HC , Tornetta PR , Tarkin I ,et al. Timing of fracture fixation in multitrauma patients: the role of early total care and damage control surgery[J]. J Am Acad Orthop Surg, 2009,17(9):541-549. DOI:
10.5435/00124635-200909000-00001
.
[48]
Marsh JL , Nepola JV , Wuest TK ,et al. Unilateral external fixation until healing with the dynamic axial fixator for severe open tibial fractures[J]. J Orthop Trauma, 1991,5(3):341-348. DOI:
10.1097/00005131-199109000-00014
.
[49]
Edwards CC , Simmons SC , Browner BD ,et al. Severe open tibial fractures. Results treating 202 injuries with external fixation[J]. Clin Orthop Relat Res, 1988(230):98-115.
[50]
Sirkin M , Sanders R , DiPasquale T ,et al. A staged protocol for soft tissue management in the treatment of complex pilon fractures[J]. J Orthop Trauma, 1999,13(2):78-84. DOI:
10.1097/00005131-199902000-00002
.
[51]
Henley MB , Chapman JR , Agel J ,et al. Treatment of type Ⅱ, ⅢA, and ⅢB open fractures of the tibial shaft: a prospective comparison of unreamed interlocking intramedullary nails and half-pin external fixators[J]. J Orthop Trauma, 1998,12(1):1-7. DOI:
10.1097/00005131-199801000-00001
.
[52]
Roberts CS , Pape HC , Jones AL ,et al. Damage control orthopaedics: evolving concepts in the treatment of patients who have sustained orthopaedic trauma[J]. Instr Course Lect, 2005,54:447-462. DOI:
10.2106/00004623-200502000-00030
.
[53]
Benirschke SK , Agnew SG , Mayo KA ,et al. Immediate internal fixation of open, complex tibial plateau fractures: treatment by a standard protocol[J]. J Orthop Trauma, 1992,6(1):78-86.
[54]
Kregor PJ , Stannard JA , Zlowodzki M ,et al. Treatment of distal femur fractures using the less invasive stabilization system: surgical experience and early clinical results in 103 fractures[J]. J Orthop Trauma, 2004,18(8):509-520. DOI:
10.1097/00005131-200409000-00006
.
[55]
Moed BR , Kellam JF , Foster RJ ,et al. Immediate internal fixation of open fractures of the diaphysis of the forearm[J]. J Bone Joint Surg Am, 1986,68(7):1008-1017. DOI:
10.2106/00004623-198668070-00007
.
[56]
Court-Brown CM , McQueen MM , Quaba AA ,et al. Locked intramedullary nailing of open tibial fractures[J]. J Bone Joint Surg Br, 1991,73(6):959-964. DOI:
10.1302/0301-620X.73B6.1955445
.
[57]
Griffin M , Malahias M , Khan W ,et al. Update on the management of open lower limb fractures[J]. Open Orthop J, 2012,6:571-577. DOI:
10.2174/1874325001206010571
.
[58]
Bhandari M , Zlowodzki M , Tornetta PR ,et al. Intramedullary nailing following external fixation in femoral and tibial shaft fractures[J]. J Orthop Trauma, 2005,19(2):140-144. DOI:
10.1097/00005131-200502000-00012
.
[59]
Govender S , Csimma C , Genant HK ,et al. Recombinant human bone morphogenetic protein-2 for treatment of open tibial fractures: a prospective, controlled, randomized study of four hundred and fifty patients[J]. J Bone Joint Surg Am, 2002,84(12):2123-2134. DOI:
10.2106/00004623-200212000-00001
.
[60]
Mundi R , Chaudhry H , Niroopan G ,et al. Open tibial fractures: updated guidelines for management[J]. JBJS Rev, 2015,3(2). DOI:
10.2106/JBJS.RVW.N.00051
.
[61]
Liu X , Zhang H , Cen S ,et al. Negative pressure wound therapy versus conventional wound dressings in treatment of open fractures: a systematic review and meta-analysis[J]. Int J Surg, 2018,53:72-79. DOI:
10.1016/j.ijsu.2018.02.064
.
[62]
Philandrianos C , Moullot P , Gay AM ,et al. Soft tissue coverage in distal lower extremity open fractures: comparison of free anterolateral thigh and free latissimus dorsi flaps[J]. J Reconstr Microsurg, 2018,34(2):121-129. DOI:
10.1055/s-0037-1607323
.
[63]
Gopal S , Majumder S , Batchelor AG ,et al. Fix and flap: the radical orthopaedic and plastic treatment of severe open fractures of the tibia[J]. J Bone Joint Surg Br, 2000,82(7):959-966. DOI:
10.1302/0301-620x.82b7.10482
.
[64]
Small JO , Mollan RA . Management of the soft tissues in open tibial fractures[J]. Br J Plast Surg, 1992,45(8):571-577. DOI:
10.1016/0007-1226(92)90022-p
.
[65]
Cho EH , Shammas RL , Carney MJ ,et al. Muscle versus fasciocutaneous free flaps in lower extremity traumatic reconstruction: a multicenter outcomes analysis[J]. Plast Reconstr Surg, 2018,141(1):191-199. DOI:
10.1097/PRS.0000000000003927
.
[66]
Hallock GG . Utility of both muscle and fascia flaps in severe lower extremity trauma[J]. J Trauma, 2000,48(5):913-917. DOI:
10.1097/00005373-200005000-00016
.
[67]
Mubarak SJ , Owen CA , Hargens AR ,et al. Acute compartment syndromes: diagnosis and treatment with the aid of the wick catheter[J]. J Bone Joint Surg Am, 1978,60(8):1091-1095. DOI:
10.2106/00004623-197759020-00008
.
[68]
McQueen MM , Court-Brown CM . Compartment monitoring in tibial fractures. The pressure threshold for decompression[J]. J Bone Joint Surg Br, 1996,78(1):99-104. DOI:
10.1302/0301-620X.78B1.0780099
.
[69]
von Keudell AG , Weaver MJ , Appleton PT ,et al. Diagnosis and treatment of acute extremity compartment syndrome[J]. Lancet, 2015,386(10000):1299-1310. DOI:
10.1016/S0140-6736(15)00277-9
.
[70]
Mubarak SJ , Owen CA . Double-incision fasciotomy of the leg for decompression in compartment syndromes[J]. J Bone Joint Surg Am, 1977,59(2):184-187. DOI:
10.2106/00004623-197759020-00008
.
[71]
Cohen MS , Garfin SR , Hargens AR ,et al. Acute compartment syndrome. Effect of dermotomy on fascial decompression in the leg[J]. J Bone Joint Surg Br, 1991,73(2):287-290. DOI:
10.1302/0301-620X.73B2.2005157
.
[72]
Debnath UK , Maripuri SN , Guha AR ,et al. Open grade Ⅲ "floating ankle" injuries: a report of eight cases with review of literature[J]. Arch Orthop Trauma Surg, 2007,127(8):625-631. DOI:
10.1007/s00402-007-0314-y
.
[73]
Zhang GC , Liang J . Experiences in treatment of traumatic amputation[J]. Orthop J Clin, 2005,13(6):479-480. DOI:
10.3969/j.issn.1005-8478.2005.06.028
.
[74]
赵国强，朱建，杨利平,等. 儿童外伤性截肢的手术治疗策略[J]. 中华急诊医学杂志, 2010,19(5):479-481. DOI:
10.3760/cma.j.issn.1671-0282.2010.05.008
.
Zhao GQ , Zhu J , Yang LP ,et al. Treatment strategy for traumatic amputation in children[J]. Chin J Emerg Med, 2010,19(5):479-481. DOI:
10.3760/cma.j.issn.1671-0282.2010.05.008
.
[75]
MacKenzie EJ , Bosse MJ , Kellam JF ,et al. Factors influencing the decision to amputate or reconstruct after high-energy lower extremity trauma[J]. J Trauma, 2002,52(4):641-649. DOI:
10.1097/00005373-200204000-00005
.
[76]
Khalil IM , Livingston DH . Intravascular shunts in complex lower limb trauma[J]. J Vasc Surg, 1986,4(6):582-587. DOI:
10.1067/mva.1986.avs0040582
.
[77]
Mathew S , Smith BP , Cannon JW ,et al. Temporary arterial shunts in damage control: Experience and outcomes[J]. J Trauma Acute Care Surg, 2017,82(3):512-517. DOI:
10.1097/TA.0000000000001334
.
[78]
Webb LX , Bosse MJ , Castillo RC ,et al. Analysis of surgeon-controlled variables in the treatment of limb-threatening type-open tibial diaphyseal fractures[J]. J Bone Joint Surg Am, 2007,89(5):923-928. DOI:
10.2106/JBJS.F.00776
.
[79]
Celikoz B , Sengezer M , Isik S ,et al. Subacute reconstruction of lower leg and foot defects due to high velocity-high energy injuries caused by gunshots, missiles, and land mines[J]. Microsurgery, 2005,25(1):3-14, 15. DOI:
10.1002/micr.20049
.
[80]
Bosse MJ , McCarthy ML , Jones AL ,et al. The insensate foot following severe lower extremity trauma: an indication for amputation?[J]. J Bone Joint Surg Am, 2005,87(12):2601-2608. DOI:
10.2106/JBJS.C.00671
.
[81]
Czerniecki JM . Rehabilitation in limb deficiency. 1. Gait and motion analysis[J]. Arch Phys Med Rehabil, 1996,77(3Suppl):S3-S8. DOI:
10.1016/S0003-9993(96)90236-1
.
[82]
Mattes SJ , Martin PE , Royer TD . Walking symmetry and energy cost in persons with unilateral transtibial amputations: matching prosthetic and intact limb inertial properties[J]. Arch Phys Med Rehabil, 2000,81(5):561-568. DOI:
10.1053/mr.2000.3851
.
[83]
Busse JW , Jacobs CL , Swiontkowski MF ,et al. Complex limb salvage or early amputation for severe lower-limb injury: a meta-analysis of observational studies[J]. J Orthop Trauma, 2007,21(1):70-76. DOI:
10.1097/BOT.0b013e31802cbc43
.
[84]
Saddawi-Konefka D , Kim HM , Chung KC . A systematic review of outcomes and complications of reconstruction and amputation for type ⅢB and ⅢC fractures of the tibia[J]. Plast Reconstr Surg, 2008,122(6):1796-1805. DOI:
10.1097/PRS.0b013e31818d69c3
.
[85]
Bosse MJ , MacKenzie EJ , Kellam JF ,et al. An analysis of outcomes of reconstruction or amputation after leg-threatening injuries[J]. N Engl J Med, 2002,347(24):1924-1931. DOI:
10.1056/NEJ-Moa012604
.
[86]
Tintle SM , Keeling JJ , Shawen SB ,et al. Traumatic and trauma-related amputations: part Ⅰ: general principles and lower-extremity amputations[J]. J Bone Joint Surg Am, 2010,92(17):2852-2868. DOI:
10.2106/JBJS.J.00257
.
[87]
Scalea TM , Boswell SA , Scott JD ,et al. External fixation as a bridge to intramedullary nailing for patients with multiple injuries and with femur fractures: damage control orthopedics[J]. J Trauma, 2000,48(4):613-621, 621-623. DOI:
10.1097/00005373-200004000-00006
.
[88]
Jansen JO , Thomas R , Loudon MA ,et al. Damage control resuscitation for patients with major trauma[J]. BMJ, 2009,338:b1778. DOI:
10.1136/bmj.b1778
.
[89]
Pape HC , Giannoudis PV , Krettek C ,et al. Timing of fixation of major fractures in blunt polytrauma: role of conventional indicators in clinical decision making[J]. J Orthop Trauma, 2005,19(8):551-562. DOI:
10.1097/01.bot.0000161712.87129.80
.
[90]
Pape HC , Schmidt RE , Rice J ,et al. Biochemical changes after trauma and skeletal surgery of the lower extremity: quantification of the operative burden[J]. Crit Care Med, 2000,28(10):3441-3448. DOI:
10.1097/00003246-200010000-00012
.
备注信息
A
余斌，南方医科大学南方医院创伤骨科，Email：
mocdef.3ab61lonibuy
B
吴新宝，北京积水潭医院创伤骨科，Email：
grodef.labatipsohtsjoabnixuw
C
唐佩福，解放军总医院第一医学中心骨科，Email：
mocdef.6ab21103gnatfp
D
张英泽，河北医科大学第三医院，Email：
mocdef.3ab61uil_gnilzy
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