ISSN:0885-9698    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThe title of this article might have been “A Debutante Surgeon's Perspective of the Ilizarov Method.” As a young surgeon from Great Britain, the junior author (M.F.P.) was minimally exposed to the use of the Ilizarov method in trauma applications with an overall magnitude of negative bias. There was very little prior experience with circular frames and like many novice ilizarovian surgeons, M.F.P. dreaded using what appears to be a very cumbersome device. After 8 months with the senior author (M.M.), however, M.F.P. has grown to accept the use of Ilizarov technique as a reliable alternative to more conventional methods of treatment. He realized that the application of a circular frame is not impossible, providing the surgeon adheres to some basic principles. Furthermore, the junior author came to appreciate that the Ilizarov method, once learned, can be successfully used in cases of severe trauma in which conventional techniques such as open reduction and internal fixation are fraught with complications—e.g., major pilon fractures. The junior author's work in the Level 1 Trauma Center (Houston, TX, U.S.A.) with the Ilizarov-trained surgeon produced a surprising discovery: a circular frame can be an extremely useful and versatile device for dealing with severe lower limb fractures.

ISSN:0885-9698    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThis article reviews external fixation mounting strategies for difficult locations and discusses combinations of tensioned wires and titanium half-pins that can be used with the Ilizarov technique.

ISSN:0885-9698    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryDisillusionment with the results of classical open techniques in the management of complex tibial plateau fractures has led to a move toward methods of indirect reduction and subsequent stabilization with external fixation. Stabilization of these complex articular injuries with the Ilizarov method, in combination with indirect reduction maneuvers such as ligamentotaxis, offers many advantages over conventional open reduction and internal fixation with plates. Smooth olive wires stabilize the joint fracture in the sagittal plane, and percutaneous cannulated screws can be added, when indicated, for fracture lines in the coronal plane. A three- or four-ring circular frame construct ensures adequate fixation of the metadiaphyseal junction, which is usually very unstable. Experience with this method has demonstrated that it provides sufficient stability to allow early joint motion while preserving the soft tissue envelope, with a low rate of complications secondary to surgical fixation.

ISSN:0885-9698    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryBone transport is a successful technique for the reconstruction of bone loss >4 cm. In the acute situation, principles of open-fracture management should be of highest priority. Conversion of a temporary four-pin monolateral external fixator to a one transport frame is carried out at the time of secondary débridement procedures. The use of free-flap coverage in concert with antibiotic cement beads is encouraged to maintain a well-vascularized transport corridor. Following corticotomy and bone transport, the flap is elevated, the antibiotic beads are removed, and can-cellous grafting of the docking site is performed. Grafting of the docking site decreases the incidence of nonunion as well as the overall treatment time. Solid union with minimal residual complications is achievable. Prolonged treatment time is the primary disadvantage of this technique, which requires strict patient compliance with pin care and patient adjustment of the external transport frame.

ISSN:0885-9698    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryWe present a technique in which soft tissue defects are covered by free flaps at the time of frame application. This technique allows treatment of segmental bone defects, nonunions, malunions, and osteomyelitis with traditional Ilizarov and modern soft tissue coverage principles. Patients undergo fewer operative procedures for treatment of wounds and have shorter hospitalizations, and the flap coverage places no limitations on distraction or translation of the fracture fragments.

ISSN:0885-9698    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummarySmall-tensioned-wire external fixation techniques can achieve excellent results in the treatment of distal tibial pilon fractures. Such techniques are especially useful in those injuries with extensive articular comminution and diametaphyseal shaft extension and those injuries with significant soft tissue compromise. An immediate ligamentotaxis reduction, followed by a traction computed tomography scan, is invaluable in the preoperative treatment of these injuries. Limited incisions may aid in the reduction of these injuries. The fixation is accomplished using small tensioned olive wires and, in some fracture patterns, cannulated screws. The technique is described herein with various traction techniques, including calcaneal traction, two-pin temporary external fixation, and ligamentotaxis through an Ilizarov-type frame.

ISSN:0885-9698    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryFemoral fractures have long been a challenge to the orthopaedist, especially those fractures with bone loss. The Ilizarov method of fracture fixation provides the ability to treat proximal, diaphyseal, and distal fractures of the femur using one system. It also provides a technique for treating complex femoral fractures with bone loss.

ISSN:0885-9698    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThe technique of percutaneous reduction using an Ilizarov fixator and Steinman pins for comminuted calcaneus fractures complicated by complex soft tissue injuries of the foot is illustrated. The technique is indicated to salvage complex foot injuries not suitable for open reduction and internal fixation.

ISSN:0885-9698    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThe technique of limited internal fixation and Ilizarov tensioned-wire external fixation to treat severely comminuted intraarticular fractures of the distal femur is illustrated. The comminuted joint surface and condylar mass are reconstructed with small-diameter screws and Steinman pins. Axial and angular alignment and augmentation of the condylar reconstruction are achieved by a tensioned-wire circular frame. The technique has successfully salvaged these severe injuries. Loss of motion of the knee is observed in all patients.

ISSN:0885-9698    

出版商:OVID    

年代:1996

数据来源: OVID