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使用大型一次性外固定器的经验。

Experience with a large-frame, disposable external fixator.

作者信息

Seligson David, Douglas Lonnie

机构信息

Department of Orthopedics, University of Louisville, Louisville, KY 40207, USA.

出版信息

Orthopedics. 2010 Mar;33(3). doi: 10.3928/01477447-20100129-12. Epub 2010 Mar 10.

Abstract

External fixation is a temporizing measure that has a long history in the treatment of fractures. Thirty-eight newly designed large-frame external fixators were applied for acute lower-limb fractures and pelvis injuries in a level I trauma center. In 75% of cases, the frames were used for first-stage skeletal stabilization, followed by revision to plates or nails 1 to 2 weeks later. The external fixators remained in place from 4 to 28 days (median, 8 days). The fixator is composed of a low-cost plastic resin and uses modular, disposable components. The montage requires only 2 varieties of clamp, monotube rods, and fixation pins already in-house. The device is lighter than conventional fixators yet equal in rigidity. Cost analysis performed by our institution demonstrated cost savings of 20% to 25% compared to conventional external fixation. The new device is packaged sterilely and does not require autoclaving before application. Patient acceptance of the device was good. There were no complications or disadvantages associated with the use of this lower-cost device. Specifically, there were no pin tract infections, no loss of fixation, and no loosening or disassembly of the devices.

摘要

外固定是一种临时措施,在骨折治疗方面有着悠久的历史。在一家一级创伤中心,38个新设计的大型外固定架被用于急性下肢骨折和骨盆损伤的治疗。在75%的病例中,这些外固定架用于一期骨骼稳定,随后在1至2周后改为钢板或髓内钉固定。外固定架留置时间为4至28天(中位数为8天)。该固定架由低成本的塑料树脂制成,采用模块化、一次性组件。组装仅需两种已有的夹具、单管杆和固定针。该装置比传统固定架更轻,但刚性相同。我们机构进行的成本分析表明,与传统外固定相比,成本节约了20%至25%。这种新装置经过无菌包装,使用前无需高压灭菌。患者对该装置的接受度良好。使用这种低成本装置没有出现并发症或缺点。具体而言,没有针道感染、固定失败以及装置松动或拆卸的情况。

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