Weber B G, Magerl F
Helv Chir Acta. 1978 Dec;45(4-5):609-18.
Not only fractures of joints and shafts may benefit from internal fixation, but also certain fractures of the spine. Stable spine fractures still are suitable for closed treatment. Instable fractures, however especially those with neurological disorders, can be much improved in their results by adequate surgery, by open reduction, rigid fixation and decompression of the medullary canal in case of paraplegia. As simple as closed treatment of the stable fractures is, as difficult is surgery of instable fractures. For all the different types of instable fractures and different types of compression syndromes, individual surgical approaches, decompression and fixation techniques are to be familiar to the surgeon. The basics of such individualized treatment of fractures of the spine are described as it has become standard base on an experience with 750 fractures of the spine, 90 of them having had surgery.
不仅关节和骨干骨折可受益于内固定,某些脊柱骨折也是如此。稳定性脊柱骨折仍适合闭合治疗。然而,不稳定性骨折,尤其是伴有神经功能障碍的骨折,通过适当的手术,如切开复位、坚强内固定以及在截瘫情况下对髓管进行减压,其治疗效果可得到显著改善。稳定性骨折的闭合治疗虽简单,但不稳定性骨折的手术却很困难。对于所有不同类型的不稳定性骨折和不同类型的压迫综合征,外科医生应熟悉个体化的手术入路、减压和固定技术。本文将介绍脊柱骨折个体化治疗的基础,这是基于750例脊柱骨折的经验(其中90例接受了手术)而成为标准的。