GeneralG11ExFixPrinciplesJTGrev2410章节幻灯片.pptVIP

* There are 3 main types of frame placement/design: Standard frame used in definitive treatment or as temporary frame Nonarticulated Joint spanning often used as a temporary “damage control” frame or allows for soft tissue recovery as in pilon fractures Articulated * The standard frame: Mainly used in diaphyseal fractures and thus, does not cross the joint Allows motion of the joints above and below the fracture Highly stable construct * Joint spanning frame Useful for comminuted intra-articular and peri-articular fracture patterns Immobilizes the joint Useful as a temporizing frame and/or as a definitive treatment in combination with limited internal fixation It is also useful in arthrodesis, especially in association with infection where internal fixation is not ideal * Articulated frame: Limited indication Allows for joint motion Complex construct with high learning curve Mainly utilized for intra-articular fracture patterns * Note docking site bone grafted * Pin Spread: A vs B,C. Increased pin spread increases overall stability of the fixator construct. * Pin Spread: A vs B,C. Increased pin spread increases overall stability of the fixator construct. * Decreased distance from bar to bone: When the fixator bar is placed closer to the bone, the overall construct is more stable as depicted in the figure as decrease deflection in reaction to equivalent forces Double Stacking of Bars: When a second connecting rod/bar is added, the overall construct is made more stable/rigid * Delta Frame: The delta configuration offers increased resistance to deformation in two planes without the need for transfixion pins, avoiding the attendant risks of neurovascular injury * Modes of Fixation: Compression Neutralization Distraction * Current External fixation systems have been designed to allow micromotion at the fracture site to promote callus formation Stable yet less rigid systems of external fixation maintain alignment and length while allowing and ac