Carroll Eben A, Koman L Andrew
Department of Orthopaedic Surgery, Wake Forest University Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
J Surg Orthop Adv. 2011 Spring;20(1):74-81.
External fixation is an important option in the acute management of unstable femoral and tibial fractures and the temporary stabilization of periarticular injuries of the knee or ankle. The value of external fixation as the modality of choice in selective civilian and military applications is well documented. Primary indications include damage control for multitrauma management in patients with concomitant traumatized integument and/or excessive swelling and/or systemic instability and stabilization for transport in hostile or austere environments. The purpose of this article is to discuss the indications for temporary external fixation of lower extremity long bones and complicated distal femoral, proximal tibia, and tibial plafond fractures; to outline technical considerations in the application of temporary external fixation devices; and to summarize the experience in the use of prepackaged external fixators and their indications in combat.
外固定是不稳定型股骨和胫骨骨折急性处理以及膝关节或踝关节周围损伤临时稳定的重要选择。外固定作为选择性民用和军事应用中的首选方式，其价值已有充分记录。主要适应证包括对伴有创伤性皮肤损伤和/或过度肿胀和/或全身不稳定的多发伤患者进行损伤控制，以及在恶劣或严峻环境中用于转运时的稳定。本文旨在讨论下肢长骨及复杂的股骨远端、胫骨近端和胫骨平台骨折临时外固定的适应证；概述临时外固定装置应用中的技术要点；并总结预包装外固定器的使用经验及其在战斗中的适应证。
