Pawn lam fixator .

1.Thuhmahruai .

External fixation hmang hian 'localized damage control' tih theih a ni a, fractures te chu soft tissue chhiatna nasa tak nei te tan leh fracture tam tak tan definitive treatment atan hman theih a ni. Ruh infection hi pawn lam fixation hmanna atana thil pawimawh tak a ni. External fixation hi deformity siamthat leh ruh hman dan atan pawh hman theih a ni.

2 .engvangin nge an hman ang . Pawn lam atanga fixation . 

2.1 Pawn lam fixation a thatna .

- Ruh chunga thisen kal dan tihbuai tlem.

- Soft tissue coverage-ah nghawng a nei tlem.

- emergency thila hman rang theih a ni.

- Open leh contaminated fractures te fixation.

- Surgery tel lo fracture te chu redistribution leh stable fixation a phalsak.

- Infection a awm chuan taksa dang a awm tlem zawk.

- Standard incisional reduction leh internal fixation (ORIF) aiin experience leh surgical skill a mamawh tlem zawk.

- Bone handling leh deformity correction tih theih a ni.

2.2 Pawn lam fixation atana hman tur indication .

2.2.1 Fracture hawn theih .

External fixation bracing hi open fractures temporary or definitive immobilization hman dan pakhat a ni a, a bik takin soft tissue hliam na tak awmnaah a langsar hle. External fixation braces hi natna kai theihna sang tak nei, clinic-a kal hun sawn leh/ emaw hliam natna hrik kai te tan a tangkai hle. External fixation hi hun rei tak chhung chu chutiang hliam tuar tan chuan hmanraw tangkai tak a ni a, gold standard anga ngaih a la ni reng bawk.

2.2.2 A khar fractures .

External fixation hman dan tur indication chu closed fractures-ah hian polytrauma na tak nei damlote chu hun eng emaw chen atana immobilization, leh closed soft tissue contusions emaw degloving injuries na tak emaw nei te an ni. Hetiang a nih chuan, pawn lam fixator hmanga temporary immobilization chu hliam awmna hmun atanga hla takah, a tha ber chu operation theihna hmun atanga hla takah tih theih a ni a, chu chuan soft tissue hliam chu limb alignment vawng reng chungin enkawl theih a ni.

2.2.3 Hliam tam tak .

Hliam tam tak nei damlote damage control surgery tih hunah external fixation frame procedure ngaihtuah tur a ni. Pawn lam fixation thatna ber chu fracture-a rapid relative stabilization a ni a, natna tihziaawmna atan a pui a, thisen chhuah a ti tlem a, enkawlna awlsam zawk nan systemic inflammatory response syndrome a tihziaawm bawk.

2.2.4 Intra-Articular fractures .

External fixation bracing hi a tlangpuiin hun eng emaw chen atana tehna a ni a, fragile soft tissue cover chu unstable fractures emaw complex intra-articular fractures emaw-ah a venghim a Joint dislocations emaw ligament repairs emaw atan pawh option a ni a, chutah chuan one-stage definitive internal fixation a awm thei lo. Joint lian zawng zawng chu hetiang hian bridge theih a ni a, mahse a tam zawk chu wrist, khup leh ke ruh te hi a ni.

2.2.5 Ruh emaw soft tissue emaw a chhiatna .

Soft tissue na tak leh ruh chhiatna nei damlote tan chuan external fixation frame hmangin stage khatah limb chu tawi te te in an ti tawi thei a, chu chu stage hnihnaah distraction osteogenesis hmangin an ke ruh sei zawng an siam tha leh thei bawk.

2.2.6 Pawn lam fixation frame indirect reset na hmanrua atana hman thin .

Fracture tihtlem hnuah, internal fixation plate emaw intramedullary nail emaw dah a nih chuan, fracture awmna chu external fixator lock-in a awm reng thei a ni. A châng chuan pawn lam fixator chu hun engemaw chen a awm theih a, chu chuan internal fixation a chak tawk loh laiin fixation dang a pe thei bawk. External fixator emaw femoral distractor te hian tibial intramedullary nail placement lai hian hmun pawimawh tak an chang tih hmuhchhuah a ni. Schnee pin chu proximal tibial intramedullary nail entry point dorsal side-ah screw a ni a, heel bone chhungah chuan, rod sei tak hmanga inzawm a ni. Hei hian localized balanced traction a pe a, intramedullary nail chu flexed emaw extended knee position emaw-a dah hmain fracture sei zawng, rotation leh axis te pawh a siamrem bawk.

Tibial intramedullary nail placement chu pawn lam fixation bracket retraction nen a inzawm a ni.

3.Principles pawn lam fixation brace hman dan tur .

3.1 Biomechanical lam hawi .

Anatomic safety zone kaltlangin major fracture block khatah pin 2 tal dah la, pin chu a zau thei ang berah dah rawh. Soft tissue conditions in a phal chuan fixation pin te chu a fracture end hnaih thei ang bera dah tur a ni a, mahse fracture end hematoma chhungah emaw, skin denudation area chhungah emaw lut tur a ni lo. Extended internal fixation ruahman a nih chuan fixation pins te hian surgical incisions leh surgical access (surgical area) awm thei te chu a pumpelh tur a ni. Connecting rods te chu ruh hnaih thei ang bera dah tur a ni a, chu chuan stability a ti sang thei ang. External fixator stability chu a hnuaia thilteah hian a innghat a ni.

- fracture tawp atanga fixation pins hlat zawng: a hnaih poh leh a chak zawk.

- Fracture block tinah fixation pins spacing: a lian zawk chuan a chak zawk.

- Ruh atanga longitudinal connecting rods hlat zawng: a hnaih poh leh a hnaih zawk.

- Connecting rod awm zat: pahnih chu pakhat aia chak an ni.

- External fixation frame (a hniam ber atanga a sang ber thlenga) configuration: Single plane/a-shape/biplane.

- External fixation frame leh internal fixation limited (tension screws) inzawmkhawm: elastic leh strong fixation mix chu hun eng emaw chen chauh a nih avangin hman a tlem hle.

- Schanz screw emaw Schnee pins diameter: 6mm hian flexural strength 5mm aiin a let hnih in a sang zawk.

ani. Unilateral single-plane single-link pawn lam fixation frame. Fracture tawp atanga pin inkar hlat zawng (x).

A hnaih poh leh a stable zawk. Main fracture block (Y) atanga pin hrang hrangte hlat zawng: a hlat poh leh a stable zawk.

A hlat poh leh a stable zawk. Longitudinal connecting rods te chu ruh atanga hlat zawng (Z): a hnaih poh leh a nghet zawk.

b. Unilateral, uniplanar, 3-rod combination external fixator hi hmanna hrang hrang, repositioning te pawh telna atana hman tangkai tak a ni.

Application hrang hrang atan model a ni a, reset technique te pawh a tel.

c. Unilateral Uniplanar Two-Link External Fixation Frame.

d. Unilateral biplane configuration (▲ configuration) a ni.

e. Bilateral configuration leh penetrating fixation pin te a awm bawk. Tunah chuan hman a harsa tawh.

Unstable external fixation hian fracture damna a tikhawtlai a, mahse external fixation frame rigid lutuk chuan a tikhawtlai bawk.

A chang chuan stable fixation dynamize a ngai a, partial emaw complete weight bearing leh/ emaw external fixation frame configuration thlak danglamin load tihpun a ngai bawk.

3.2 Needle dahna hmanrua ruat sa .

- Nerve, thisen kalna kawng leh tendon hliam tuar lo turin anatomy hi hre chiang rawh.

- Fixation pin emaw screw emaw joint chhunga luh phal loh tur.

- Fracture tawp leh hematomas awm loh tur.

- Skin dehiscence emaw contusion emaw awmna hmunte chu pumpelh rawh.

- Bone cortex chu thermal damage awm loh nan pre-drill rawh (ring necrosis thlenga kal).

- Fixation pins chu frame remchang siam turin a sei tawk tur a ni.

3.2.1 Backbone .

Drill emaw fixation pin emaw a sharper chuan a lum a tlem zawk ang. Screwing a rang poh leh a temperature a sang zawk ang. Ruh thermal damage hi ngaihtuahawm tak a ni a, hei hian ringed dead bone a siam thei a, chu chuan a hnuah a ti hlim hmasa thei a, a kai thei bawk. Fixation pin dik taka dah chuan cortices pahnih ah hian grip tha tak a nei tur a ni a, tip erawh chu a luh thui lutuk tur a ni lo.

3.2.2 Diaphys 1000 a ni.

Epiphysis-ah chuan heat production hi harsatna a ni lo. Hetiang hunah hian self-drilling screw hman hi a him zawk mai thei, screw-a screw-a screw-a dah hian pre-drilled holes te chu hmuh loh a awlsam avangin. Joint chhunga fixation pin penetration chu joint chhunga needle tract infection seeding a awm theihna a awm avangin pumpelh a ngai a ni.

3.2.3 Hriselna hmun tur .

Nerve, thisen kalna, tendon, leh taksa ruh hliam loh nan surgeon chuan cross-section zawng zawngah a ke ruh (anatomy) a hriat chian a ngai a, fixation pin dahna atan safety zone a hmang tur a ni.

Figure 3.3.3-2 Pawn lam fixation pin dahna tur safe zone.

A femur a ni.

Figure 3.3.3-2 (chhunzawm) 1.1.

b tibia a ni.

Figure 3.3.3-2 (chhunzawm) 1.1.

C Humerus, hnunglam atanga thlir.

Plane pakhata hman a nih chuan Schanz screw chu anterior tibial crest-ah a khalh a ngai lo. Anterior tibial crest hian cortical bone thick tak a nei a, drilling hian a lum lutuk a siam thei a, chu chuan secondary osteonecrosis a thlen thei a ni. Distal tibia-ah chuan anterior tibialis tendon leh extensor digitorum muscle te hliam theihna a awm a.

4. Components 1.1.

4.1 Tube-rod system hmanga siam a ni.

4.1.1 Schanz screw 1000 a ni. 

Schanz screw hi a then chu threaded fixation pin a ni. Diameter hrang hrang, a sei zawng (rod length, thread length) leh tips hrang hrang a awm bawk. Standard Schanz screw tip chu trocar ang maia tip (Fig. 3.3.3-3a) a ni a, a tlangpuiin pre-drilling a ngai thin.

Figure 3.3.3-3 Schanz screw te hi a ni.

A standard socket pin ang chi tip.

B Self-drilling tip.

Self-drilling leh self-tapping pin te hian screw in an tih hian a rualin thread drill leh cut thei tur special sharp tip an nei a, metaphysis-a hman tur atana siam an ni (Fig. 333-3b).

Schanz screw hi steel, titanium emaw hydroxyapatite emaw hmanga siam a ni. Hydroxyapatite coated pins hian ruhah grip tha tak a siam thei a, ruh natna hmasa ber a siam thei a, a lo chhuak lo thei bawk. Hetiang pin chi hi hun rei tak chhung external fixators awmna hmuna awm tan a tha hle.

4.1.2 Steiner pins a ni.

Steiner pin hi ruh lut thei fixation pin atan an hmang tlangpui. An tips te chu drill sleeves ang chiah a ni a, insertion hmain cortical bone ah pre-drilled a ngai a ni.

4.1.3 Tube/rods 1000 a ni.

Tube/rods te specification a zirin model hrang hrang 4 a awm a:

• A lian: 11 mm tube/rod, Schanz screw chu 4~6 mm a ni.

• Medium: 8 mm tube/rod, Schanz screw te chu 3~6 mm a ni.

• A te: 4 mm tube/rod, Schanz screw 1.8 atanga 4 mm.

• MINI: Kut zungtang tan 2 mm system, design pangngai, K-wire leh 2 mm rod siam that nan multi-pin clamp a awm.

He system a module te hi pre-shaped, curved carbon fiber rods hmanga tihpun a ni. Fixation site harsa tak tak, wrist ang chi tan chuan T-joint module pawh a awm bawk.

4.1.4 Clamp 1000 a ni.

Clamp te hi tube/rod leh fixation pin te connect nan hman a ni. Tube/rods te pawh hi clamp (tube-tube) tha tak hmangin an inzawm thei bawk.

Figure 3.3.3-5 clamp te hi a ni.

Schanz screw leh tube/rods inzawmkhawmna tur self-locking clamp.

b Rod emaw tube pahnih inzawmkhawmna tur combination clamp.

c Universal multi-pin clamp.

D tube pahnih inzawmkhawmna tur D tube-tube clamp.

4.2 Unilateral pawn lam fixation frame system .

Fracture block hi double-pinned clamp emaw customized clamp emaw hmangin control theih a ni. Central threaded component chu ruh sei leh/ emaw ruha phurh chhuahna atan distraction emaw compression emaw atan attached theih a ni.

Unilateral external fixation system chu ruh atanga phurh chhuahna atan hman a ni.

4.3 Pawn lam fixation inzawmkhawm .

Combined external fixation hi joint bula fractures atan hman a ni a, ring fixation atan tensioned Kirschner pin leh diaphysis atan Schanz screw pangngai a ngai a ni. 3/4 circumferential ring hman a ni tlangpui. Combination ring fixator hi proximal leh distal tibia atan hman a ni ber.

Tibial plateau fractures atan pawn lam fixation brace inzawmkhawm. Distal tibia periarticular fractures atan pawh hman theih a ni. V-shaped structure hian stability tha tak a pe a ni edics .

4.4 Circumferential pawn lam fixation brace .

Fully circumferential external fixation system thatna chu load bearing leh orthopedic axis axis chu circumferential external fixation system lairil atanga longitudinal axis a kal tlang a ni. Circumferential external fixator system hi ruh ti sei thei, ruh hman dan, leh simple leh complex fracture enkawlna atan hman theih a ni.

Tibial ring pawn lam fixation brace .

Tibial ring external fixation system a clinical thlalak a ni.

He technique hman hian early weight bearing a phal a ni. Fracture thar atan chuan enkawlna atan unilateral external fixation frame awlsam tak kan duh zawk. Bone handling leh lengthening pawh chutiang bawkin unilateral external fixation system hmanga enkawl theih a ni a, mahse, complex, sustained, multiplanar deformity corrections tih chu a harsa thei a, chu chu circumferential external fixator a ni. Pawn lam fixation atana hman a nih chuan circumferential external fixator hian relative stability a pe a ni. Multiplanar fixation atana plane hrang hrang kal tlanga needle an kalpui chuan he structure hian stability sang tak a pe a ni. Structure chakna hi fixation configuration, ring hman zat leh pin hman chi hrang hrang, Kirschner pin emaw Schanz screw emaw a zirin a danglam thei. Assembly a zirin fracture chu retract emaw compress emaw a ni thei a, deformity pawh siamthat theih a ni bawk. Ring external fixators hi ruh chhiatna, tawi leh deformities siamthat nan osteogenesis distraction atan an hmang tlangpui.

4.5 Hinged Pawn lam fixation brace .

dislocated joint emaw fracture dislocations emaw repositioning neih reng nan leh joint stiffness venna atana (controlled) joint motion thenkhat phalsak nan hman thin a ni. Elbow joint atan hman a ni tlangpui.

5 Frame Pawn lam fixation brace siam dan .

5.1 Frame structure-a hming vuah dan .

Frame structure hrang hrangte categorize dan hrang hrang a awm a, a bik takin:

- Thiltih.

- Frame design a ni.

- A hman dan tur ruahmanna.

- characterization a ni.

5.1.1 Unilateral Frame hrang hrang .

Unilateral frame hi diaphyseal fracture thar enkawlna atana hman tlanglawn ber external fixator frame modality a ni. Frame hi plane pakhatah an hnawih a, eg anteromedial emaw medial emaw tibia leh anterolateral emaw lateral emaw femur-ah an hmang thin. Fixation pin te chu a sir khatah vun hmangin an dah a, double cortex an luhchilh a ni. Pin chu joint atanga hla takah dah tur a ni a, joint capsule-a reflexed portion pawnah, joint sepsis awm loh nan. Rod pahnih hi plane khatah emaw, plane hrang hrang pahnih emaw-ah an dah a, chutah chuan an inzawm khawm a ni.

5.1.2 Bilateral Frame 1000 a ni.

Szczecin pin chu a sir khatah vunah a kal a, bilaminar cortex chhungah a lut a, chu chu a sir lehlamah vunah a kal a ni. Bilateral frame hi fractures definitive treatment atan a tha lo a, mahse temporary fixation atan erawh hman theih a ni.

5.1.3 Pawn lam fixation frame crossed .

Damage control procedure-a hman thin, soft tissue hliam na tak emaw, intra-articular fracture leh fracture dislocations complex tak tak emaw awmna hmun span-na atan hman a ni.

▲Pelvic fractures, proximal femur fractures, leh proximal tibia fractures te chu khup leh ankle joint hrang hranga temporary external fixation braces hmangin immobilized an ni.

External fixation frame-in a pek stability hian soft tissue recovery bakah CT scanning leh preoperative planning atan pawh a phalsak a ni. Unilateral frame hman tam ber a ni a, fixation pin te chu hliam na hmun leh nakin lawka definitive surgery performance pawnah dah tur a ni.

5.1.4 Extension frame 10 a awm.

Ilizarov hian he technique hi circumferential external fixation frame hmangin a rawn hmang tan a. Tubular external fixation frame leh unilateral external fixation frame hmangin he principle of slow retraction hi hman theih a ni a, a chhiatna chu angular leh rotational deformities pahnih siamthatna chu intramedullary nailing hmanga lengsening tih a nih loh chuan a hun takah tih theih a ni lo.

5.2 Patterned Repositioning Techniques .

Combined external fixation frame thatna chu ruh sei zawng zawng, joint bula awm zawng zawng, leh joint ngei (transarticular) te tihtlem, bridging, leh fixation a phalsak a ni.

Schanz screw dahna chu liberal a ni thei a, chu chuan Schanz screws te tana anatomic fixation position tha ber thlan theihna emaw, fracture leh soft tissue injury chi hrang hrang a zirin optimal area of fixation emaw a phalsak thei a ni. Fracture fragment lian ber berte tihtlem nan hian leverage leh indirect reduction technique hmangin tih theih a ni a, chutih rualin ruh leh soft tissue-a thisen kal chu a humhim thei bawk. He technique hman hian engtik lai pawhin fracture reduction chu a siam thar leh thei a ni.

Combined reduction technique hmanga siam a ni.

A type B tibial stem fracture a ni.

B Fracture block lian ber apiangah hliam na hmun pawnah fixation pin 2 an screw lut thin.

C fixation pins chu universal clamps hmanga connecting rods-ah a innghat a, chu chuan indirect fracture reduction atan handle 2 a siam a ni.

D Fracture a awm leh hnuah 3rd connecting rod chu a hmasa ber 2 connecting rods ah tube-tube clamp hmangin a inzawm a.

▲ Pawn lam fixation brace inzawmkhawm a entir. A tibia a ni. b Femur a ni. c trans-knee a ni.

6 A bik taka hmanna .

6.1 Joint fusion .

External fixators hman bik chu joint te compression hmanga bilateral external fixators inzawmkhawm hi a ni. He principle hi a chang chuan ke ruh, khup leh elbow ruh inzawmna atan hman a ni a, a bik takin infection awmnaah chuan .

6.2 Infection .

External fixation hi acute infection emaw infected nonunion of a fracture emaw enkawlna hnuhnung ber a ni a, fixation pin te hi infection awmna hmun atanga hla takah dah theih a nih avangin.

6.3 Siamhatna osteotomy .

Osteotomies for correction of deformities soft tissue dinhmun a chhe emaw, a chhe emaw a nih chuan internal fixation hman theihna a sang a, chutiang a nih chuan external fixation brackets chu fixation atan hman theih a ni. A danglamna dang chu osteotomy a ni a, a ruala ruh hman dan a ni. Hei hian a tlangpuiin circumferential external fixation frame hmanga siamthat a ngai tlangpui.

6.4 Ruh hman dan - distraction osteogenesis .

Bone distraction hi Ilizarov-a’n periosteum humhalhna principle atanga a siam a ni a, chutiang chuan uluk taka severed bone chu zawi zawiin a tibuaitu (0.5-1 mm/d) a awm thei a, chu chu he gap-ah hian ruh thar a lo awm thei a ni. Distraction rates slow zawk chuan ruh damna a thlen a, chutih laiin tissue strain tolerance aia tam distraction rates chak zawk chuan ruh a siam lo. Bone scab phurh emaw, ngaihtuahna tibuaitu emaw, ruh tliak ang chi te pawh hian ruh damna a thlen hma loh chuan scab puitlin hun lai zawng zawng a paltlang bawk. He technique hman dan tur indication 3 a awm a, a chang chuan heng indication te hi a awm dun thei bawk:

- Limb a sei.

- ruh chhiatna enkawl nan segmental bone handling.

- siamthatna (osteotomy) siamhat.

Chumi atana fixation frame tha ber chu circumferential external fixation frame (semi-circumferential external fixation frame nei emaw nei lo emaw) leh unilateral external fixation frame te hi a ni.

6.5 Joint Restoration leh Sustained Motion .

Hinged external fixator hi complex unstable elbow injury engemaw zat a belhchhahtu pawimawh tak a ni a, chung zingah chuan incisional repositioning leh ligament repair hnua chronic emaw unresolved elbow dislocations te pawh a tel. Hinged external fixator chuan elbow reset chu controlled mobilization hmangin a vawng reng thin. Repositioning vawn reng hi a hmasa ber a ni. Instability hi loss of motion aiin enkawl a harsa zawk. Axis chu fluoroscopy hnuaiah chiang taka dah a ngai a ni. Hinge awmna hmuna inthlak danglamna tlemte hian a hnathawh a nghawng nasa hle.

▲ Elbow atan hinged external fixator dah a ni.

7 Operative-a enkawlna hun hman dan .

7.1 Pin tract enkawlna .

Pin tract reaction hi fixation pin awmna leh stability, nursing team leh damlo postoperative treatment-ah a innghat a ni. Combined reduction technique hi a hlawk zawk a, a chhan chu fracture chi hrang hrang a zirin fixation pin atana anatomical position tha ber thlan a phalsak a ni. Hospital hian pin tract care process chiang tak a nei tur a ni a, nurse thiam tak takte chuan damlote chu anmahni chauhin pin tract care tih dan tur an zirtir tur a ni. Pin insertion laiin thermal injury leh local hematoma formation pumpelh a, zu disinfectants hmanga pin site tihfai hnua tihfai a, closed pressure dressings hman a nih chuan pin infection leh loosening chu nasa takin a tlahniam thei a ni.

7.2 Pin tract in a kai theih . 

Pin tract care hian pin insertion dik tak a nei hmasa tur a ni. Schanz screw pangngai tan chuan pre-drilling a ngai tlangpui a, pin chu thermal necrosis tihtlem nan kut hmanga screw in a ni. Pin vel a soft tissue tension dik lo chu surgery neih chhung hian a chhuak tur a ni. Pin tract enkawlna dik tak neih a pawimawh a, chu chuan pin tract complication awm zat a tihziaawm theih nan. Pin tract infection leh screw loosening chu pin loose chu la chhuakin hmun dangah pin pakhat re-screwing hmangin a chinfel theih a ni.

7.3 Mobilization .

External fixator bul tannaah hian special case tlemte (bridging fixation, emergency use, tension adjustment) tih loh chu partial weight bearing phal a ni. Damdawi a lo kal zel chuan full weight bearing pawh a pung zauh zauh thei a ni. External fixator ah hian dynamization device dang dah belh a ngai tawh lo. Partial emaw full weight bearing hi dynamization hman dan tha ber leh tangkai ber a ni.

8 Pawn lam fixation hun chhung .

8.1 Enkawl dan thlak danglam .

Enkawlna bulpui 3 a awm a:

• Fracture a dam hma loh chuan external fixator chu definitive treatment atan hmang ang che.

• Internal fixation-a inthlak hma.

• Non-surgical treatment, plaster, orthosis, etc. ang chi hmanga enkawlnaah inthlak rawh.

Internal fixation-a inthlak beisei a nih chuan a hma thei ang bera tih a ngai a ni (kar 2 chhungin) a chhan chu complication rate chu late conversion aiin a hniam zawk hle a ni.

A hnuaia dante hi hun eng emaw chen atana fixation hma, hun leh a hnua surgery eng pawh ruahman hunah zawm tur a ni:

• Original external fixation site vel a implant thar dah a nih chuan pin tract zawng zawng chu a fai vek tur a ni. A châng chuan a kalphung chu stage hnih-ah tih a ni a, stage khatah original pin tract tihfai nan leh a pahnihna chu definitive fixation tih theih a ni.

• Ni 10 atanga ni 14 aia upa pin tract site eng pawh chu colonized anga ngaih a ni a, definitive fixation hmain aseptically-a tihfai leh debrided tur a ni.

• Heng pin tract site emaw pin tract emaw hi a sterility a nih chuan rinhlelhna a awm a nih chuan, implant thar dah hmain pin tract debridement hnuah ni 10 tal 'pin rest period' a ngai a ni.

• Antibiotics hi antimicrobial spectrum hmanga prophylactically hman a ngai a, chu chuan pin tract infection hmasa atanga bacteria te chu a khuh vek tur a ni.

• Internal fixator thlak atanga kar 6 hmasa berah follow-up khar tur a ni.

Pin tract-a harsatna a awm tih finfiahna a awm chuan bacteria chi hrang hrangte hriat chian a, antibiotics hmanga pin thlak leh dah leh a, external fixator hmanga enkawl chhunzawm zel a tha ber. Pin tract care hian damlo chu a result tha ber tur a nih theih nan a huam tur a ni. External fixator chu late stage-a internal fixation hmanga thlak a ngai a nih chuan 'pin rest period' ni 10 tal neih a tha a, chu chu external fixator lakchhuah hnuah pin tract chu tihfai leh debride hmasa tur a ni a, chutah chuan internal fixation surgery a tlai hmain pin tract problem a chinfel hma loh chuan splint hmangin fix tur a ni. Hemi hun chhung hian antibiotics hi a remchan dan angin hman theih a ni.

8.2 Fixation hnuhnung ber .

Emergency external fixation hian limb chu hun eng emaw chen atan a stability a nei thei a, soft tissue recovery a phalsak thei bawk. Soft tissue conditions a stable chhung chuan external fixator chu final internal fixation hmangin a thlak theih a ni. A tha ber chu ni 10 chhunga internal fixation hmanga thlak tur a ni.

Pawn lam fixation chu a la nghet a, harsatna a awm loh chuan replacement fixation a ngai lo. Skin coverage a tha lo a nih chuan, a nih loh leh soft tissue chhiatna nasa tak a awm a, open reduction atanga kai theihna a sang a nih chuan, external fixator chu a tawp bera fracture enkawlna atan vawn reng theih a ni.

Fracture damna kal zel dan hi uluk taka enfiah a ngai a, hmasawnna a awm loh chuan enkawlna dang ngaihtuah a ngai a ni.