Green D R
Clin Podiatry. 1985 Jan;2(1):95-119.
There are several ways to avoid the iatrogenic complications or hazards of internal fixation. The surgical approach should be planned well in advance. The instruments and materials to be used intraoperatively should be checked before beginning the operation to assure that there are adequate materials of appropriate length and thickness. Also, all materials should be checked for major defects (see Fig. 11A). Good tissue dissection and atraumatic surgical technique is essential to limit excessive tissue destruction. Reduction of the fracture fragments should be obtained prior to fixation. While applying fixation devices, the fragments should be held stable. Intraoperative radiographs are necessary to demonstrate appropriate positioning of the internal fixation device and the proper alignment of the fracture fragments. If the alignment is not satisfactory, repositioning of the devices can and should be made. Preoperative practice and familiarity with the fixation devices is an essential part of shortening the operative time and helping to assure optimum fixation stability. A poor time to learn the techniques for internal fixation is during surgery. Good postoperative care is essential to optimize fracture fragment healing results.
有几种方法可以避免内固定的医源性并发症或风险。手术入路应提前精心规划。术中使用的器械和材料在手术开始前应进行检查，以确保有足够长度和厚度合适的材料。此外，所有材料都应检查是否有重大缺陷（见图11A）。良好的组织解剖和无创手术技术对于限制过度的组织破坏至关重要。在固定之前应使骨折碎片复位。应用固定装置时，碎片应保持稳定。术中X线片对于显示内固定装置的合适位置和骨折碎片的正确对线是必要的。如果对线不满意，可以且应该重新调整装置的位置。术前练习并熟悉固定装置是缩短手术时间并有助于确保最佳固定稳定性的重要部分。在手术过程中学习内固定技术可不是个好时机。良好的术后护理对于优化骨折碎片愈合结果至关重要。
