St-Jean G, Clem M F, DeBowes R M
Department of Surgery and Medicine, College of Veterinary Medicine, Kansas State University, Manhattan 66506-5606.
J Am Vet Med Assoc. 1991 Jan 1;198(1):139-43.
Medical records of 5 calves with tibial fractures that were reduced and stabilized by transfixation pinning and casting were reviewed. Multiple Steinmann pins were placed transversely through proximal and distal fracture fragments, and the pin ends were incorporated in fiberglass cast material after fracture reduction. Cast material serves as an external frame to maintain pin position and fracture reduction. Calves were between 2 weeks and 6 months old and weighed between 40 and 180 kg. Three fractures were spiral in configuration and 2 were comminuted. One tibial fracture was open. After surgery, all calves were ambulatory within 24 hours. To improve tarsal flexion and achieve normal stance in 3 calves, cast revision was required on the caudal aspect of the limb. Good radiographic and clinical evidence of stability was observed in 5 to 10 weeks (mean 8 weeks), at which time the pis and cast were removed. Return to normal function was rapid and judged to be excellent at follow-up evaluation 3 to 12 months later. Advantages of transfixation pinning and casting in management of tibial fractures include flexibility in pin positioning, adequate maintenance of reduction, early return to weight-bearing status, joint mobility, and ease of ambulation. The inability to adjust fixation and alignment after cast application is a disadvantage of this technique compared with other external fixators.
回顾了5头接受经皮穿针固定和石膏固定治疗胫骨干骨折的犊牛的病历。多根斯氏针横向穿过近端和远端骨折块，骨折复位后针尾埋入玻璃纤维石膏材料中。石膏材料作为外部框架以维持针的位置和骨折复位。犊牛年龄在2周龄至6月龄之间，体重在40至180千克之间。3处骨折为螺旋形，2处为粉碎性骨折。1处胫骨干骨折为开放性骨折。术后，所有犊牛在24小时内即可行走。为改善跗关节屈曲并使3头犊牛达到正常站立姿势，需要对肢体尾侧进行石膏修正。在5至10周（平均8周）时观察到良好的影像学和临床稳定性证据，此时取出钢针和石膏。恢复正常功能迅速，在3至12个月后的随访评估中判定为极佳。经皮穿针固定和石膏固定治疗胫骨干骨折的优点包括针定位的灵活性、复位的充分维持、早期恢复负重状态、关节活动度以及行走便利性。与其他外固定器相比，石膏应用后无法调整固定和对线是该技术的一个缺点。
