Weinberg A M, Reilmann H, Lampert C, von Laer L
Unfallchirurgische Klinik, Städtischen Klinikums Braunschweig.
Unfallchirurg. 1994 Mar;97(3):107-13.
In a retrospective study 89 shaft fractures sustained during childhood and treated by external fixation were analysed [80 fractures of the lower extremity (59 of the femur) and 9 of the upper extremity]. The operative investment (operating time, period of hospitalization, time for fluoroscopy, general anaesthesia, start of mobilization, number of X-rays) correlated with the success of the treatment. The overall complication rate was 19.1%. Technical errors occurred in 5.6% of all cases; the infection rate was 4.5%; refractures were seen in 4.5% of all patients and reinfarction also in 4.5%. The last 10 femur fractures were analysed separately and the overall complication rate was demonstrably reduced to 3.2%. All technical errors are avoidable and the infection rate could be minimized by better care of the pin, exit points, and by ensuring more stable anchorage of the screws. The consolidation time is longer than with plate osteosynthesis and medullary nailing. But in contrast to adults, in children the treatment was completed with external fixation, and no pseudarthrosis was seen. The consolidation time was shorter with dynamic external fixation. With dynamic systems healing took an average of 7 weeks, while rigid systems needed an average of 9 weeks. Refractures and reinfarction were caused by the rigidity of the external fixation system. In isolated dislocated shaft fractures in childhood the advantages of the fixateur externe are its easy application, low level of invasiveness and early mobilization. It was used in all kinds of fractures in children aged 4-13 years.
在一项回顾性研究中，分析了89例儿童期发生并采用外固定治疗的骨干骨折[80例下肢骨折（59例股骨骨折）和9例上肢骨折]。手术投入（手术时间、住院时间、透视时间、全身麻醉、开始活动时间、X线片数量）与治疗成功率相关。总体并发症发生率为19.1%。所有病例中技术失误发生率为5.6%；感染率为4.5%；所有患者中骨折不愈合率为4.5%，再梗死率也为4.5%。对最后10例股骨骨折进行单独分析，总体并发症发生率明显降至3.2%。所有技术失误都是可以避免的，通过更好地护理钢针、出口点并确保螺钉更稳定的固定，感染率可以降至最低。与钢板内固定和髓内钉固定相比，骨愈合时间更长。但与成人不同，儿童通过外固定完成治疗，未出现假关节。动态外固定的骨愈合时间更短。使用动态系统时，平均愈合时间为7周，而刚性系统平均需要9周。骨折不愈合和再梗死是由外固定系统的刚性引起的。在儿童期单纯性脱位骨干骨折中，外固定架的优点是应用简便、侵入性低和早期活动。它用于4至13岁儿童的各种骨折。
