Mathieu Laurent, Ouattara Naklan, Poichotte Antoine, Saint-Macari Erwan, Barbier Olivier, Rongiéras Fréderic, Rigal Sylvain
Clinic of Traumatology and Orthopaedics, Desgenettes Military Hospital, Lyon, France.
Int Orthop. 2014 Aug;38(8):1569-76. doi: 10.1007/s00264-014-2305-2. Epub 2014 Mar 11.
External fixation is the recommended stabilization method for both open and closed fractures of long bones in forward surgical hospitals. Specific combat surgical tactics are best performed using dedicated external fixators. The Percy Fx (Biomet) fixator was developed for this reason by the French Army Medical Service, and has been used in various theatres of operations for more than ten years.
The tactics of Percy Fx (Biomet) fixator use were analysed in two different situations: for the treatment of French soldiers wounded on several battlefields and then evacuated to France and for the management of local nationals in forward medical treatment facilities in Afghanistan and Chad.
Overall 48 externals fixators were implanted on 37 French casualties; 28 frames were temporary and converted to definitive rigid frames or internal fixation after medical evacuation. The 77 Afghan patients totalled 85 external fixators, including 13 temporary frames applied in Forward Surgical Teams (FSTs) prior to their arrival at the Kabul combat support hospital. All of the 47 Chadian patients were treated in a FST with primary definitive frames because of delayed surgical management and absence of higher level of care in Chad.
Temporary frames were mostly used for French soldiers to facilitate strategic air medical evacuation following trauma damage control orthopaedic principles. Definitive rigid frames permitted achieving treatment of all types of war extremity injuries, even in poor conditions.
在外军前沿外科医院，外固定是长骨开放性和闭合性骨折推荐的固定方法。特定的战斗外科战术最好使用专用外固定器来实施。基于此，法国陆军医疗服务部门研发了珀西外固定器（百美公司生产），该外固定器已在多个战区使用了十多年。
分析了珀西外固定器（百美公司生产）在两种不同情况下的使用战术：用于治疗在多个战场受伤后被疏散至法国的法国士兵，以及用于阿富汗和乍得前沿医疗设施中当地居民的治疗。
总共为37名法国伤员植入了48个外固定器；28个框架为临时使用，在医疗后送后转换为确定性刚性框架或内固定。77名阿富汗患者共使用了85个外固定器，其中包括在前方外科医疗队（FST）抵达喀布尔战斗支援医院之前应用的13个临时框架。由于乍得的手术管理延迟且缺乏更高水平的护理，47名乍得患者均在前方外科医疗队接受了初次确定性框架治疗。
临时框架主要用于法国士兵，以便按照创伤损害控制骨科原则进行战略空中医疗后送。确定性刚性框架能够实现对各种类型战争肢体损伤的治疗，即使在条件较差的情况下也是如此。
