Borrione F, Jouve J L, Louis R
Service de Chirurgie Orthopédique et Traumatologique, Hôpital Hôtel-Dieu, Marseille, France.
Surg Radiol Anat. 1988;10(4):283-9. doi: 10.1007/BF02107899.
Ilizarov's method of implanting an external circular fixator requires the placement of at least 8 transfixion pins. The neurovascular hazards and the need to leave the posterior and lateral compartments free motivated this study, based on serial radiographic sections after injection of the entire arterial system. Two reference pin-planes were determined, 1 posterolateral and 1 lateromedial. The sites of insertion of the pins rely on classical radiographs of the bones of the leg. The addition of beaded pins must be made on a realigned and stabilized limb. The imprecision of aim due to the bone structure and the shape of the pin leads to the definition of forbidden zones where any transfixion is dangerous. The concept of a neurovascular pyramid with its base at the distal metaphysis and of a periosseous tendinous circlet at that level implies a search for a compromise between the stability of the assembly and the dangers of the method.
伊里扎洛夫植入外固定环的方法需要至少置入8根贯穿针。基于对整个动脉系统注射造影剂后的系列X线断层扫描，神经血管损伤风险以及需要使后外侧肌间隔保持完整促使了本研究的开展。确定了两个参考针平面，一个在后外侧，一个在外侧内侧。针的插入部位依据小腿骨骼的传统X线片确定。带珠针必须在肢体复位并稳定后添加。由于骨骼结构和针的形状导致的瞄准不精确，引出了禁止区域的定义，在这些区域进行任何贯穿操作都是危险的。在干骺端远端为基底的神经血管金字塔概念以及该水平的骨膜腱环概念意味着要在装置稳定性和该方法的风险之间寻求折衷。
