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The past 25 years have seen a progressive improvement in external
fixation techniques in terms of patient acceptability, ease of appli
cation and apparatus stability. The recent awareness in Europe of
the method, application and excellent results of the technique pio
neered by G. A. Ilizarov has caused a rapid increase here in the
number of surgeons who have become "banderilleros". In particu
lar, external fixators can be used in the treatment of difficult clini
cal conditions, such as severe fractures and their sequelae, as well
as for the correction of congenital deformities of the peripheral
skeleton.
As one of the first in France to use the Ilizarov method, I became
increasingly aware that we needed an updating of anatomical
knowledge oriented towards this technique, which uses multiple
fixation pins. Without this anatomical information, there is real
danger of damaging neuro-vascular structures or entering a joint in
the course of assembling the fixator. Traditional anatomical cross
sections are often inadequate or too schematic to serve as a safe
guide for the surgeon using this particular technique. This is the
reason why my colleagues Claude Faure and Philippe Merloz have
produced and analysed a series of anatomical cross-sections of the
limbs to serve this particular need.
Colour photographs of the cross-sections show the size and dispo
sition of the neuro-vascular bundles and bone, which are often
found in unexpected areas. Each photograph is accompanied by a
diagram, shown on the opposite page, which indicates areas related
to simple landmarks where transfixation is either safe or danger
ous. Cutaneous zones related to the safe areas are also depicted
and carefully analysed. Computerised tomographic scans of nor
mal anatomical structures at relevant levels complete the atlas and
provide comparisons with aberrant scans obtained in clinical prac
tice.
Claude Faure and Philippe Merloz have provided us with an ex
tremely useful guide. It has been a great pleasure to see the fruits of
their work. This atlas is a fine example of their excellent collabora
tion. |
