Dougherty Paul J, Vickaryous Brian, Conley Edgar, Hickerson Kyle
Department of Surgery, William Beaumont Army Medical Center, El Paso, TX, USA.
Clin Orthop Relat Res. 2003 Jul(412):176-83. doi: 10.1097/01.blo.0000071751.41516.b5.
Temporary external fixation of femur fractures, used at civilian trauma centers for patients who cannot tolerate more extensive procedures, also is planned for use in military field hospitals to provide temporary stabilization and allow for safe transport of a patient to the next level of care. The purpose of the current study was to evaluate three constructs: an external fixator made by one manufacturer and two Hoffman II constructs: uniplanar and biplanar. The study consisted of two parts: a biomechanical study of each of the three constructs and the application of each of the two Hoffmann II constructs to separate cadaver thighs by resident surgeons. Five resident surgeons participated in the study using five pairs of cadaver thighs. The biplanar construct was stiffer in axial and torsional stability when compared with the uniplanar construct. There was no difference in the amount of time needed to apply the constructs nor was either construct found to be subjectively easier to apply by the surgeons. There was an increased number of unicortical pins and plunges (when a pin inadvertently slips over the side) with the uniplanar construct when compared with the biplanar. The biplanar construct is biomechanically more stable and appears to allow for more accurate placement of pins.
股骨骨折的临时外固定，在民用创伤中心用于无法耐受更广泛手术的患者，也计划在军事野战医院使用，以提供临时稳定，并使患者能够安全转运至下一级护理机构。本研究的目的是评估三种结构：一种由一家制造商生产的外固定器和两种霍夫曼II型结构：单平面和双平面结构。该研究包括两个部分：对三种结构中的每一种进行生物力学研究，以及住院外科医生将两种霍夫曼II型结构中的每一种应用于不同的尸体大腿。五名住院外科医生使用五对尸体大腿参与了该研究。与单平面结构相比，双平面结构在轴向和扭转稳定性方面更硬。应用这些结构所需的时间没有差异，外科医生也没有主观上觉得哪种结构更容易应用。与双平面结构相比，单平面结构的单皮质针和穿刺（当针意外滑到一侧时）数量增加。双平面结构在生物力学上更稳定，似乎能使针的放置更准确。
