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Orthopedic Technology: External Fixation of Fractures


At present, the application of external fixation brackets in the treatment of fractures can be divided into two categories: temporary external fixation and permanent external fixation, and their application principles are also different.

Temporary external fixation.
It is suitable for patients whose systemic and local conditions do not allow or cannot tolerate other treatments. If there are no fractures with burns, they are only suitable or tolerated for temporary fixation with external fixation brackets. After the systemic or local conditions improve, the external fixation is removed. Plate or intramedullary nailing, but it is also possible that this temporary external fixation remains unchanged and becomes the ultimate fracture treatment.
It is suitable for patients with severe open fractures or multiple injuries that are not suitable for internal fixation. When it is difficult to choose a better internal method for such injuries, external fixation is a better fixation method.

Permanent external fixation.
When using permanent external fixation to treat fractures, it is necessary to master and understand the mechanical characteristics of the scaffolds used and their influence on the fracture healing process, so as to ensure that external fixation scaffolds are used in the entire fracture healing process, and ultimately achieve satisfactory bone healing. , and related problems that may arise during the process, such as needle tract infection and local discomfort, also need to be considered.
When using external fixation as a permanent method to treat fresh fractures, a stent with good external fixation strength should be used, and early firm and stable fixation may provide the best environment for local soft tissue and early fracture healing. However, the time of this strong internal fixation should not be maintained for too long, because it will block the local stress of the fracture and cause osteoporosis, degeneration or nonunion at the fracture site. The fractured end gradually bears the load, which is beneficial to stimulate and promote the process of local bone healing until the fracture is firmly healed. Clinically, once the local bone healing phenomenon occurs, the early callus fracture site is formed, and gradually bearing the load can transform the early callus into a healing callus. This pure pressure or hydrostatic pressure at the fracture end can stimulate the differentiation of interstitial cells, which requires a sufficient local blood supply, otherwise it will affect the bone healing process. Factors affecting the bone healing process include the local blood supply at the fracture site and the external Fixed methods and so on.

In the treatment of external fixation for fractures, local strong fixation should be achieved, and then the fixation strength should be gradually reduced to allow the fracture end to bear the load and promote the bone healing process to obtain a consensus, but how long does it take to change the fixation strength to allow the fracture end? The optimal time window to start taking the load is completely clear. The fixation of fractures by external fixator is a kind of flexible fixation. The principle of this flexible fixation is the basis of today's locking plate. Its structure is similar to external fixation, including using longer plates and fewer screws to achieve better results Treatment effect: The screw is locked on the steel plate to achieve a useful fixation effect.

Based on the same principle, the ring-shaped stent achieves initial firm fixation through multi-directional needle threading. Initially, weight-bearing is reduced to maintain local firm fixation. Later, weight-bearing is gradually increased to increase axial fretting and provide stimulation to the fracture end to promote fracture healing and fixation. The frame itself is tough and stable, and the same result is achieved in the end.