摘要:

SummaryThe emergency treatment of pelvic ring injuries is dictated by the amount of pelvis instability, the presence of associated injuries, and the patient’s condition. In this respect, timing is everything, and therefore a comprehensive protocol for the acute treatment of pelvis fractures is mandatory. The initial evaluation of the patient should follow the Advanced Trauma Life Support (ATLS) standards. As part of the initial assessment, pelvis instability should be identified and the diagnosis of a pelvic fracture can then be confirmed on a plain anteroposterior radiograph of the pelvis. Most displaced pelvis fracture should be stabilized immediately. If the patient is hemodynamically stable, a more definitive type of fixation may be performed initially. External fixation is particularly useful in cases of anterior pelvic instability, open fractures of the anterior pelvis, pelvis fractures associated with polytrauma, especially intra-abdominal injuries requiring open exploration, and as the initial stabilization tool of a staged method for definitive pelvis fixation. In this latter scenario, external fixation may be a life saving procedure by closing down and reducing the pelvic fracture and the anatomy of the retroperitoneum, thus creating a tamponade effect on small caliber bleeding vessels.3,5,13,17,22,27,29,33,36Contraindications for external fixation include pelvic fractures through the iliac wing or those fractures associated with fractures of the acetabulum that need open reconstruction. A relative contraindication is a pure vertical displacement of both SI joints. External fixation is not the best means of definitive fixation for posterior unstable fractures of the pelvis, especially those with vertical translation. The purpose of this article is to familiarize the reader with external fixation of the pelvis while reviewing indications, tips, advantages, and disadvantages of this technique.

ISSN:0885-9698    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

SummaryThe approach to pelvic fractures has undergone substantial change throughout the years. Considerable controversy exists concerning this fracture in terms of hemorrhage etiologies, treatment options, complications, and outcomes. External fixation became popular when conservative treatment was found to be less successful than previously thought. Although there is a trend away from external fixation as internal fixation continues to emerge, external fixation has a definite role in pelvic fracture management. The authors review the indications and techniques for external fixation in the management of pelvic fractures.

ISSN:0885-9698    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

SummaryThis article discusses the application of femoral external fixators, with emphasis on the cross sectional anatomy, mechanical considerations, and fixator configurations.Safe,unsafe, andhazardouscorridors are described, with recommendations for optimal and ideal pin placement. Fixator configurations and the biomechanics are touched upon, with suggestions for difficult clinical situations such as osteopenic bone, small fracture fragments, and heavy patients.

ISSN:0885-9698    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

SummaryA deep knowledge of anatomic structures and pathways is an indispensable prerequisite for successful use of external fixation in the upper extremity. Bone substance and dimensions in the different areas should be taken into account as well as the position of the muscle bellies and gliding spaces between functional muscle groups and tendons, not least to mention the course of nerves and vessels. In some respects the surgeons view differs markedly from the anatomists view. Both are aware of anatomic structures but the surgeons who, for example, have to stabilize a long-bone fracture concentrates on safety corridors, trying to avoid damage to nerve and vessel routes as well as to other soft-tissue structures. The following description of anatomic features is meant to provide viewpoints and data for unilateral external fixation in the upper extremity without laying claim to completeness.

ISSN:0885-9698    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

SummaryThis article reviews the current indications for external fixation in the management of wrist fractures. It describes the operative technique, postoperative care, and possible complications.

ISSN:0885-9698    

出版商:OVID    

年代:2002

数据来源: OVID