External Fixation Indications and Techniquesppt外固定的适应症和techniquesppt.ppt

External FixationIndicationsand Techniques Objectives Identify the following as they pertain to external fixation: Advantages disadvantages Indications Types of frames Biomechanics stability Pre-operative planning Common complications External Fixator A device placed outside the skin that stabilizes bone fragments with pins or wires connected to bars “Relative stability “ Healing with callus External FixationAdvantages Minimal damage to blood supply Minimal damage to soft tissues Fixation is away from site of injury Good option when significant infection risk External FixationDisadvantages Restricted joint motion Pin tract infection Cumbersome Inadequate stability for certain fractures Indications Most commonly used: Tibia Distal radius Less commonly used: Femur Humerus Forearm Indications Open fractures Closed fractures with soft tissue compromise Periarticular fractures Polytrauma/Damage control Pelvic fractures Children’s fractures Open Fractures Avoids injury site Avoids additional injury to soft tissues and vascularity Open Fractures Open Fractures Segmental bone loss Open Fractures Fractures needing nerve or vessel repair Closed Fractures with Soft Tissue Compromise Swelling Fracture blisters Closed Fractures with Soft Tissue Compromise Crush injuries Burns Closed Fractures with Soft Tissue Compromise Compartment syndrome Periarticular Fractures Severe fractures with joint involvement and shaft extension Periarticular Fractures Periarticular Fractures Hybrid Fixator: Thin wires near joint Pins (Schanz Screws) in shaft Periarticular Fractures Reduce and fix the joint surface Span the diaphyseal segment without disturbing soft tissues Periarticular Fractures External fixation can be combined with internal fixation Polytrauma Temporary stabilization of long bone injuries in unstable patient Minimally invasive Decreases bleeding Pain control Nursing care “Damage control” Pelvic Fractures Tempor