股骨开放性骨折的治疗现状与进展  

Current status and progress in the treatment of open femoral fractures

作　　者：梁羽[1] 刘绍江[1] 钟凤林[1] Liang Yu;Liu Shaojiang;Zhong Fenglin(Department of Orthopedics,Panzhihua Central Hospital,Panzhihua 617067,Sichuan Province,China)

机构地区：[1]攀枝花市中心医院骨科,攀枝花617067

出　　处：《中国基层医药》2023年第12期1907-1912,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：四川省医学会骨科疾病(尚安通)专项科研课题(2021SAT24)。

摘　　要：股骨开放性骨折的发生率相对少见,大多数由高能量创伤引起,且常见于多发伤患者。因股骨开放骨折病情重、合并伤多、致残率高、感染率高、截肢率高使之成为下肢最难治疗的骨折之一。目前,针对I度和Ⅱ度股骨开放骨折,在患者伤情稳定情况下,大多数学者推荐一期彻底清创骨折切开复位内固定,而针对Ⅲ度股骨开放骨折,许多研究仍推荐分期手术治疗,但一期骨折的固定方式仍存在较多争议。关于严重股骨开放骨折的保肢与截肢,医师团队应根据临床经验、可用资源、患者和近亲属的期望等综合因素制定出合理的个体化抉择,而不是仅仅依据保肢或截肢评分系统做出最终的治疗方案。该文就股骨开放骨折的流行病学、分型、手术治疗、保肢与截肢的相关报道进行综述,旨在为临床医师治疗股骨开放性骨折提供一些参考意见。The incidence of open femoral fractures is relatively low,primarily caused by high-energy trauma and often associated with multiple injuries.The management of open femoral fractures is considered one of the most challenging lower limb injuries due to their serious nature,multiple traumas,high disability rate,high infection rate,and high amputation rate.Most scholars currently recommend that open grade I and grade II fractures of the femur be treated with thorough debridement and open reduction,and internal fixation at the initial stage when the patients are in good condition.However,for open grade III femur fractures,many studies still show that staged treatment strategies are preferred,but the fixation method at the initial stage is still controversial.For patients with severe open femoral fractures,the medical team should create an individualized treatment plan,taking into account the patient's and family's preferences,the medical team's experience,and available resources,rather than simply relying on the salvage or amputation scoring system to make the final decision.This review discusses the epidemiology,classification,surgical management options,and strategies for limb salvage and amputation in the treatment of open femur fractures,providing practical guidance for healthcare professionals who manage these patients.

关 键 词：骨折 开放性 股骨骨折 流行病学 骨折固定术 预后 综述 

分 类 号：R683[医药卫生—骨科学]