Krettek C, Miclau T, Grün O, Schandelmaier P, Tscherne H
Trauma Department, Hannover Medical School, Germany.
Injury. 1998;29 Suppl 3:C29-39. doi: 10.1016/s0020-1383(98)95006-9.
In an effort to limit the amount of soft tissue dissection at the fracture site, indirect reduction and minimally invasive fixation techniques have been developed to treat femoral and tibial fractures. These techniques, which do not rely upon anatomical reduction of the fracture fragments, are technically difficult. Correct limb length, axial alignment in the frontal and sagittal plane, and rotation must be assessed using means other than open reduction. In this technical note, some simple and effective intraoperative clinical examination and radiographic techniques to determine limb alignment are described. These include: the 'cable techniques' for the determination of varus-valgus malalignment; the 'hypertension test', 'radiographic recurvatum sign', 'tibial plateau sign', and 'meterstick technique' for length analysis; and the 'hip rotation test', 'lesser trochanter shape sign', 'cortical step sign', and 'diameter difference sign' for rotational analysis. For each of the listed techniques, basic principles, technical instructions, limitations, advantages, and disadvantages are described.
为了限制骨折部位的软组织剥离量，已经开发了间接复位和微创固定技术来治疗股骨和胫骨骨折。这些技术不依赖于骨折碎片的解剖复位，技术难度较大。必须使用切开复位以外的方法评估肢体长度、额状面和矢状面的轴向对线以及旋转情况。在本技术说明中，描述了一些简单有效的术中临床检查和影像学技术来确定肢体对线情况。这些技术包括：用于确定内翻-外翻畸形的“缆线技术”；用于长度分析的“高血压试验”、“影像学后凸征”、“胫骨平台征”和“米尺技术”；以及用于旋转分析的“髋关节旋转试验”、“小转子形状征”、“皮质台阶征”和“直径差异征”。针对每种列出的技术，描述了其基本原理、技术说明、局限性、优点和缺点。
