ここまでできる究極の重度四肢外傷再建

The Treatment of Severe Extremity Trauma: Key Points

はじめに

　「ある症例はうまくいって，別の症例ではうまくいかない」

　重度四肢外傷は，個々の症例において初期状態からの骨軟部損傷の把握や治療への積極的介入・スピード感など複数の要素があり，外傷が重度であるほど早く深い判断かつ高い経験値が重要になる。そこで，本稿では重度の四肢外傷治療を具体例とともに，おのおのの治療のポイントについて解説する。

　Severe extremity trauma refers to a state in which bones, joints, and soft tissues are simultaneously and extensively damaged. It is often believed that most healthcare facilities can handle bone and joint injuries along with soft tissue injuries ʻappropriatelyʼ if the injuries can be treated. Many moderate-to-mild open fractures are treated through collaboration between orthopedic and plastic surgeons, but even when both of these specialists are involved, the treatment doesnʼt always go smoothly. On the other hand, there are facilities that almost certainly can complete the treatment for any type of case. What factors account for this difference? A proactive assessment of bone and soft tissue injuries from the initial condition of each case, timely interventions, and a sense of urgency in treatment are likely to be involved. The more severe the trauma, the more that crucial early and accurate assessments and high levels of experience become. This article explains the key points of treating severe extremity trauma and provides specific examples.