GustiloⅢB和ⅢC高能量胫骨骨折--截肢与保肢的比较

截肢和保肢患者长期的功能和心理结果相似。如果早期不截肢而采取保肢,就必须考虑到:二期截肢的风险(5%～14%)、潜在的并发症(保肢术通常更高)以及住院时间延长。由于胫骨骨折严重程度不同采取的治疗可能不同(G ustiloⅢC型比ⅢB型更可能截肢),这使得对比很困难,而且相关的队列研究文献很少。

Gustilo type Ⅲ B and Ⅲ C high-energy tibial fractures Amputation versus lower-limb reconstruction

Patients treated with amputation had similar long-term functional and emotional outcomes as patients treated with reconstructive surgery. When considering reconstructive surgery over primary amputation, one must consider the risk of secondary amputation (range 5-14% ), potential complications (generally higher among reconstructive surgery patients), and length of hospital stay. The literature is limited to a paucity of cohort studies that make this comparison, which may be confounded by severity of the fracture since patients with more severe tibial fractures (Gustilo type Ⅲ C versus type Ⅲ B) are more likely to be treated by amputation.