Beals T C
Department of Orthopedic Surgery, University of Utah School of Medicine, Salt Lake City 84132, USA.
Orthop Clin North Am. 2001 Jan;32(1):205-14. doi: 10.1016/s0030-5898(05)70204-2.
There is a growing base of literature that supports the use of external ring fixators in the treatment of complex foot and ankle fractures. Clinical studies that determine definitively the optimal treatment for particular injuries are absent. Small wire ring fixators have a growing role in allowing the stabilization of complex skeletal injuries with a minimum of iatrogenic soft tissue injury. Ring fixators should be considered in the algorithm of treatment of complex lower extremity fractures with associated significant soft tissue injury. One of the cornerstones of trauma management is the preservation of reconstructive options after injury. As interest in ankle arthroplasty increases and experience broadens, such options may be available to patients who sustain severe tibial plafond or talus fractures. It is imperative that hindfoot alignment and height be maintained and infection avoided so that reconstructive osteotomy, arthrodesis, and arthroplasty remain as options for patients who sustain severe trauma.
越来越多的文献支持使用外固定环治疗复杂的足踝骨折。目前尚无明确确定特定损伤最佳治疗方法的临床研究。小型钢丝环固定器在以最小的医源性软组织损伤稳定复杂骨骼损伤方面发挥着越来越重要的作用。对于伴有严重软组织损伤的复杂下肢骨折的治疗方案，应考虑使用环固定器。创伤管理的基石之一是在损伤后保留重建选择。随着对踝关节置换术的兴趣增加和经验的积累，对于遭受严重胫骨平台或距骨骨折的患者，可能会有这样的选择。必须保持后足对线和高度并避免感染，以便重建截骨术、关节融合术和关节置换术仍然是严重创伤患者的选择。
