Rüedi T P, Sommer C, Leutenegger A
Department of Surgery, Kantonsspital, Chur, Switzerland.
Clin Orthop Relat Res. 1998 Feb(347):27-34.
The most important and demanding part of operative fracture treatment concerns the reduction and correct alignment of the fracture fragments, which must be gentle to the bone and surrounding soft parts to preserve the essential blood supply to all tissues. The so called indirect reduction techniques apply the principles of nonoperative fracture care (ligamentotaxis) in combination with surgical tools and a number of techniques, where by the exposure of the most critical fracture focus can be minimized. New implant designs, low contact plates, cannulated screws, unreamed nails, pinless and hybrid external fixators, are helpful adjuncts: however, the surgical technique remains of paramount importance. The essence of careful handling of the soft and hard tissues has been stressed time and again. With the introduction of biological or minimally invasive surgery, the techniques of indirect reduction have had a renaissance. A few examples are described.
手术治疗骨折最重要且要求严格的部分涉及骨折碎片的复位和正确对线，这必须轻柔地对待骨骼和周围软组织，以保留所有组织至关重要的血液供应。所谓的间接复位技术将非手术骨折治疗原则（韧带整复）与手术工具及多种技术相结合，借此可将最关键骨折部位的暴露降至最低限度。新型植入物设计，如低接触钢板、空心螺钉、未扩髓髓内钉、无针和混合式外固定器，都是有用的辅助手段：然而，手术技术仍然至关重要。对软组织和硬组织的小心处理的要点已被反复强调。随着生物或微创手术的引入，间接复位技术得以复兴。现描述几个例子。
