Dahners L E
Department of Orthopaedics, University of North Carolina, Chapel Hill, USA.
J Orthop Trauma. 1997 Jul;11(5):374-7. doi: 10.1097/00005131-199707000-00014.
For many years, the fracture table has served as the gold standard for the application of the distraction forces necessary to indirectly reduce fractures during internal fixation procedures. However, the fracture table is expensive, often is cumbersome, requires intraoperative adjustment by "nonscrubbed" personnel, can be difficult to use in the care of multiply traumatized patients, and often is unsuitable for the morbidly obese patient. This technical note describes the application of distraction with a sterile device that is used "in the surgical field" and applies distraction from a K-wire (or Steinman pin) tensioner to either another K-wire tensioner or a "perineal post." The multiply traumatized patient who is placed on a radiolucent table for thoracoabdominal procedures can undergo intramedullary nailing using this device without requiring transfer to a fracture table (or alternatively without requiring that surgical team members apply manual distraction during the nailing procedure). Such a device also can be used to apply distraction for tibial nailing, for indirect reduction and plating, and for hip and ankle arthroscopy.
多年来，骨折手术台一直是内固定手术中施加间接复位骨折所需牵张力的金标准。然而，骨折手术台价格昂贵，通常很笨重，需要“非刷手”人员在术中进行调整，在治疗多发伤患者时使用可能很困难，而且通常不适合肥胖患者。本技术说明描述了一种无菌装置的应用，该装置在“手术区域”使用，通过克氏针（或斯氏针）张力器向另一个克氏针张力器或“会阴柱”施加牵张力。对于因胸腹部手术而躺在透射线手术台上的多发伤患者，使用该装置可进行髓内钉固定，而无需转移至骨折手术台（或者在钉固定过程中无需手术团队成员施加手动牵张力）。这种装置还可用于胫骨钉固定时施加牵张力、间接复位和钢板固定以及髋关节和踝关节镜检查。
