Frank M, Dzupa V, Smejkal K, Baca V, Dedek T
Department of Surgery, University Hospital Hradec Kralove, Sokolska 581, Hradec Kralove, 500 05, Czech Republic.
Department of Orthopaedics and Traumatology, Third Faculty of Medicine of Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
Eur J Trauma Emerg Surg. 2014 Oct;40(5):601-6. doi: 10.1007/s00068-013-0362-7. Epub 2014 Jan 8.
Dislocated acetabular fractures in polytraumatized patients are very challenging cases to deal with. Temporary stabilization by skeletal traction is difficult in these patients. A more effective solution can be an external fixation.
The authors designed a new crossover external fixation frame for acetabular fracture. The aim of this study is the biomechanical testing of this frame on human cadavers.
This study is an experiment on ten human cadavers. The acetabular fracture C2.2 was created. The stabilization effect of external fixation was compared with stabilization by large distractor. Femoral heads' shifts caused by standardized manipulation with the cadaver were obtained from X-ray pictures.
The mean total shift in stabilization technique by external fixation was 2.56 (1-4) mm. In stabilization by large distractor, the mean of the total shift after cadaver manipulation was 5.11 (0-10) mm. No significant differences were found between stabilization by external fixation and by large distractor (p = 0.066).
The stabilization of acetabular fracture C2.2 by a crossover external fixator is as effective as large distractor. The crossover external fixation could be a suitable solution for the temporary stabilization of acetabular fractures in polytraumatized patients. Subsequent studies including clinical trials are necessary to confirm the authors' suggestion.
多发伤患者的髋臼骨折脱位是极具挑战性的病例。对这些患者而言，通过骨牵引进行临时固定很困难。更有效的解决办法可能是外固定。
作者设计了一种用于髋臼骨折的新型交叉外固定架。本研究的目的是在人体尸体上对该外固定架进行生物力学测试。
本研究是一项针对十具人体尸体的实验。制造髋臼C2.2型骨折。将外固定的固定效果与大型撑开器的固定效果进行比较。通过尸体的标准化操作引起的股骨头移位是从X线片获得的。
外固定稳定技术中的平均总移位为2.56（1 - 4）毫米。在使用大型撑开器固定时，尸体操作后的平均总移位为5.11（0 - 10）毫米。外固定与大型撑开器固定之间未发现显著差异（p = 0.066）。
交叉外固定器对髋臼C2.2型骨折的固定效果与大型撑开器一样有效。交叉外固定可能是多发伤患者髋臼骨折临时固定的合适解决方案。后续包括临床试验在内的研究有必要证实作者的建议。
