Mears D C, Fu F
Orthop Clin North Am. 1980 Jul;11(3):465-79.
The treatment of unstable pelvic ring fractures, markedly comminuted and displaced acetabular fractures, and combinations of these insults to the pelvis has been an unsolved problem in orthopedics up to the present time. Of the previous methods of treatment, external fixation has appeared to hold the most promise for certain major pelvic insults, especially those accompanied by instability of the pelvic ring. Many of the previously used external fixation devices, however, have not provided adequate stability. Recently we have modified the Hoffmann external frame to provide a simple method of treatment for unstable pelvic ring fractures that permits the patient to undergo immediate mobilization from bed to chair. Certain other complex central acetabular fractures and combined insults involving the pelvic ring, central acetabulum, and proximal femur have been treated by extensive external frames. The results of these methods are described. Although such external devices appear to be superior to previously available methods, nevertheless, in view of their inherent limitations, we have begun to explore possible methods of internal fixation of the posterior portion of the disrupted pelvic ring combined with internal or external fixation of the anterior segment of the pelvis.
不稳定骨盆环骨折、明显粉碎性和移位性髋臼骨折以及这些骨盆损伤的组合，至今仍是骨科领域尚未解决的问题。在以往的治疗方法中，外固定对于某些严重的骨盆损伤似乎最具前景，尤其是那些伴有骨盆环不稳定的损伤。然而，许多先前使用的外固定装置并未提供足够的稳定性。最近，我们对霍夫曼外固定架进行了改良，以提供一种治疗不稳定骨盆环骨折的简单方法，使患者能够立即从床上转移到椅子上活动。某些其他复杂的中央髋臼骨折以及涉及骨盆环、中央髋臼和股骨近端的联合损伤，已通过广泛的外固定架进行治疗。本文描述了这些方法的结果。尽管此类外固定装置似乎优于先前可用的方法，但鉴于其固有的局限性，我们已开始探索对骨盆环后部进行内固定并结合骨盆前部内固定或外固定的可能方法。
