Fractures of the extremities with severe open soft tissue damage. Initial management and reconstructive treatment strategies

摘要: The successful management of open extremity injuries continues to represent a surgical challenge requiring structured and multidisciplinary treatment concept. strategy depends on specific parameters, including the overall injury severity, life threatening trauma components, degree oft soft tissue injury, ischemia time, contamination wound as well age accompanying diseases patient. fractures with high-grade is guided by severity damage neurovascular damages, type fracture, state patient based clearly defined reconstructive algorithm sequentially employing initial (debridement), stabilisation fracture coverage. includes radical serial debridements vessel reconstruction, followed gradual reconstruction bone, tendons nerves subsequent plastic coverage.The sequential priority-orientated implementation these steps decisive for long term outcome, which ideally results in an regular healing bone without presence infection good regain function.