Hierholzer G, Kleining R, Hörster G, Zemenides P
Arch Orthop Trauma Surg (1978). 1978 Aug 30;92(2-3):175-82. doi: 10.1007/BF00397956.
The conclusion from the above clinical and experimental presentation is that stabilization by using external fixation in problematic cases is the method of choice because the risk of infection is better than by using the standard methods of plating and nailing. Using external fixation based on the tubular system of ASIF we can achieve rigid stability. Correct application allows early mobilization ensuring alignment even in bone defects. This method of treatment also facilitates the care of wounds. Our experimental and clinical information provides us with the opportunity to offer a systematic classification of each individual type of external fixation and its merits, as described above in types I, II, and III and its application in different situations. Our clinical experience also shows that external fixation has greatly reduced the risk of amputation in these problematic cases, but it has not solved all the problems associated with the primary injury. The advantage of the three-dimensional external fixation type III can also be seen in the case of arthrodesis of the knee joint. Here there is a better neutralization of the bending moment, than by using type II. Finally we would like to emphasize that the external fixation is not the panacea for every problematic case and each surgeon should be well aware of its methodical and correct application, as abuse of external fixation may lead to secondary complications.
从上述临床和实验情况得出的结论是，在疑难病例中使用外固定进行稳定固定是首选方法，因为其感染风险低于使用标准的钢板固定和髓内钉固定方法。基于AO/ASIF管状系统使用外固定，我们能够实现坚固的稳定性。正确应用可允许早期活动，即使在骨缺损情况下也能确保对线。这种治疗方法也便于伤口护理。我们的实验和临床信息使我们有机会对每种外固定类型及其优点进行系统分类，如上文所述的I型、II型和III型，以及其在不同情况下的应用。我们的临床经验还表明，外固定在这些疑难病例中大大降低了截肢风险，但它并未解决与原发性损伤相关的所有问题。III型三维外固定的优势在膝关节融合病例中也可见到。在此，与使用II型相比，它能更好地中和弯矩。最后，我们要强调的是，外固定并非解决所有疑难病例的万灵药，每位外科医生都应充分了解其方法和正确应用，因为滥用外固定可能导致继发性并发症。
