Alonso J, Geissler W, Hughes J L
University of Alabama, Birmingham 35233.
Clin Orthop Relat Res. 1989 Apr(241):83-8.
The role of external fixation in the management of femoral shaft fractures is reviewed based on a study of 24 femoral fractures managed by either an AO or a Wagner external fixator during 1983-1986. Indications included open fractures with soft-tissue injury (13 patients), comminuted shaft fractures (six patients), and unstable operative candidates (five patients). In 14 patients, external fixation was a temporary method (Group I), while in ten patients it was the definitive method of stabilization (Group II). Twenty-one patients achieved solid union, two developed a delayed union, and one had a nonunion. Three patients developed pin-tract infections, and one developed osteomyelitis after intramedullary fixation in Group I. Two patients in Group II developed shortening (2.1 cm and 3.2 cm). Loss of motion occurred in 11 patients, averaging 56 degrees. It is suggested that external fixation be considered in the following types of femoral fractures: open fractures for aggressive management of soft-tissue injuries; closed fractures in severely traumatized, burn, or head injury patients; fractures about the knee resulting in floating knees; and infected femoral nonunions and pseudarthroses.
基于一项对1983年至1986年间采用AO或瓦格纳外固定器治疗的24例股骨干骨折的研究，对外部固定在股骨干骨折治疗中的作用进行了综述。适应证包括伴有软组织损伤的开放性骨折（13例患者）、粉碎性骨干骨折（6例患者）以及不稳定的手术候选者（5例患者）。14例患者中，外固定是一种临时方法（第一组），而在10例患者中，它是确定性的稳定方法（第二组）。21例患者实现了牢固愈合，2例出现延迟愈合，1例出现不愈合。3例患者发生针道感染，第一组中有1例在髓内固定后发生骨髓炎。第二组中有2例患者出现短缩（分别为2.1厘米和3.2厘米）。11例患者出现活动度丧失，平均为56度。建议在以下类型的股骨干骨折中考虑使用外固定：用于积极处理软组织损伤的开放性骨折；严重创伤、烧伤或头部受伤患者的闭合性骨折；导致浮动膝的膝关节周围骨折；以及感染性股骨干不愈合和假关节。
