Raschke M J, Hoffmann R, Khodadadyan C, von Fournier C, Südkamp N P, Haas N P
Unfall-und Wiederherstellungschirurgie, Virchow-Klinikum, Humboldt-Universität zu Berlin.
Unfallchirurg. 1995 Dec;98(12):627-32.
Ring fixation of the tibia is difficult because of soft tissue transfixation and the size and weight of the external fixator. To increase the patients comfort K-wire and half-pin fixation are combined in a new hybrid configuration. The Ilizarov ring fixator with K-wire or Schanz screw fixation is combined with the unilateral AO fixator. This configuration has so far been used in 17 cases: in the proximal and intraarticular tibia in 7 cases, in the distal tibia in 8 cases and in the femur in 2 cases. As experience with the hybrid system widens indications accepted are metaphyseal and intraarticular fractures of the tibia with severe soft tissue damage, open fractures, segmental defects and fractures of the tibia that cannot be nailed. Loosening of the hybrid construction requiring an additional operative procedure has not occurred. The hybrid system is minimally invasive and allows early weight-bearing. It has the advantages of less transfixation of the soft tissue, an easy operative technique and more comfort with higher patient compliance, and the options for corrective procedures are the same as with the conventional Ilizarov technique. Our preliminary first experience with this system is encouraging; it is especially useful for problematic epi- and metaphyseal fractures with severe soft tissue damage.
由于软组织贯穿固定以及外固定器的尺寸和重量，胫骨的环形固定很困难。为了提高患者的舒适度，克氏针和半针固定以一种新的混合构型相结合。带有克氏针或斯氏针固定的伊里扎洛夫环形固定器与单侧AO固定器相结合。到目前为止，这种构型已应用于17例患者：7例用于胫骨近端和关节内，8例用于胫骨远端，2例用于股骨。随着对这种混合系统经验的增加，适用的指征包括伴有严重软组织损伤的胫骨干骺端和关节内骨折、开放性骨折、节段性缺损以及无法进行髓内钉固定的胫骨骨折。尚未出现需要额外手术的混合结构松动情况。该混合系统微创且允许早期负重。它具有软组织贯穿固定少、手术技术简便、患者舒适度更高且依从性更好的优点，并且矫正手术的选择与传统伊里扎洛夫技术相同。我们对该系统的初步首次经验令人鼓舞；它对于伴有严重软组织损伤的棘手的骨骺和干骺端骨折特别有用。
