Riassunto
Le indicazioni all’impiego della fissazione esterna nel trattamento delle fratture iuxta-articolari e dei loro esiti sfavorevoli dipendono dall’azione, sul segmento scheletrico interessato, di vari fattori strettamente collegati fra loro: sistemi di fissazione, tipo di patologia, tipo di trattamento (programma pre-operatorio, operatorio, post-operatorio), paziente, team ortopedico.
L’incessante sviluppo degli apparecchi di fissazione esterna circolare e delle tecniche di applicazione ha aperto nuove prospettive in questo campo.
I nuovi sistemi “hexapod” (sistemi esapodalici o a sei assi) a controllo computerizzato, che permettono un’ampia possibilità di azione sui segmenti scheletrici con correzione simultanea di tutti gli spostamenti, e le attuali tecniche di applicazione degli elementi di presa sull’osso, basate su ricerche anatomiche, consentono di ottenere un miglioramento della versatilità dei fissatori, della tollerabilità dei montaggi e della qualità dei risultati.
Abstract
Indications to the use of external fixation in the management of periarticular fractures and their negative outcomes are dependent on the action of different factors (strictly connected) on the bone segment: systems of external fixation, kind of injury, kind of treatment, patient, orthopaedic team.
The continuous improvement of circular external fixation systems and of techniques of application opened new possibilities in this field.
The new computer-aided hexapod systems (six axes systems), that allow a wide possibility of action on the bone segments with simultaneous correction of all kinds of displacement, and the current techniques of insertion of the bone fixation elements, based on anatomic researches, make possible to obtain an improvement of the versatility of the devices, of the tolerance of the devices and of the quality of the results.
Bibliografia
Mora R (ed) (2000) Tecniche di compressione-distrazione. Indicazioni e limiti. Amplimedical, Milano
Alonso JE, Hughes JL (1990) External fixation of the femur. AAOS Instr Course Lect 39:199–204
Mostafavi HR, Tornetta P (1997) Open fractures of the humerus treated with external fixation. Clin Orthop Relat Res 337:187–197
Mora R (ed) (2006) Nonunion of the long bones. Springer, New York
Ilizarov GA (ed) (1992) Transosseous osteosynthesis. Springer, Berlin
Volkov M, Oganesian O (eds) (1987) External fixation: joint deformities and bone fractures. University Press, Madison
Kalnberz VK (ed) (1981) Compression-distraction apparatus. Stress and rigid system. LNIITO, Riga
Samchukov M, Cherkashin A, Terrell W (eds) (2010) True-Lok general principles. Orthofix North America, Lewisville
Stewart D (1965) A platform with six degrees of freedom. Proc Instn Mech Eng 180:371–386
Gough VE, Whitehall SG (1962) Universal tire test machine. Proc FISITA 9th International Technical Congress, pp 117–137
Taylor JC (2002) Six axis deformity analysis and correction. In: Paley D (ed) Principles of deformity correction. Springer, Berlin, pp 411–436
De Coster TA, Stevens MA (1997) Safe extracapsular placement of tibia transfixation pins. Proc AAOS 64th Annual Meeting, San Francisco
Stavlas P, Polyzois D (2005) Septic arthritis of the major joints of the lower limb after periarticular external fixation: are conventional safe corridors enough to prevent it? Injury 36:239–247
Green SA (1996) External fixation mounting strategies for difficult locations. Tech Orthop 11:115–124
Moroni A, Vannini F, Mosca M, Giannini S (2002) State of the art review: techniques to avoid pin loosening and infection in external fixation. J Orthop Trauma 16:189–195
Trace R (1997) Antimicrobial silver coating reduces external fixation pin-tract infections. Orthop Today 17:1–2
Voos K, Rosenberg B, Fagrhi M, Seligson D (1999) Use of a tobramycin-impregnated polymethylmethacrylate pin sleeve for the prevention of pin-tract infection in goats. J Orthop Trauma 13:98–101
Davies R, Holt N, Nayagam S (2005) The care of pin sites with external fixation. J Bone Joint Surg 87:716–719
Cavusoglu AT, Serhan M, Inal S et al (2009) Pin site care during circular external fixation using two different protocols. J Orthop Trauma 23:724–730
Field C, Morgan K (eds) (2005) External fixation pin care protocol utilizing ionic silver site dressing. Educare, Denver
Amanti A, Potalivo G, Pelosi F et al (2010) Randomized prospective study on the use of Eufiss in the prevention of infections in patients treated with external fixation. Eur J Inflamm 8:189–192
Putti V (1942) Decalogo delle fratture. Chir Organi Mov 27: 131–135
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Pedrotti, L., Bertani, B., Tuvo, G. et al. Applicazioni iuxta-articolari della fissazione esterna: le indicazioni. Aggiornamenti 18, 65–70 (2012). https://doi.org/10.1007/s10351-012-0011-3
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DOI: https://doi.org/10.1007/s10351-012-0011-3