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Conversion from external fixation to definitive fixation: periarticular injuries.

Extremity injuries sustained by uniformed service combatants pose a significant challenge to military orthopaedic surgeons. The wounding mechanisms in Operation Iraqi Freedom and Operation Enduring Freedom consist of blasts, penetrating injuries, and blunt injuries. The mortality of warriors has decreased overall because of the improvements in head, neck, and torso body armor. Consequently, the severity of extremity wounds has increased. Because of the far-forward surgical assets (surgeons and advanced equipment), these patients are stabilized rapidly and their injured extremities are treated early (ie, revascularized, débrided, stabilized). However, multiple challenges exist in the timing of definitive reconstructive efforts once these injured service members return to military medical centers in the continental United States.

External Fixators↗

Biodegradable wire fixation in olecranon and patella fractures combined with biodegradable screws or plugs and compared with metallic fixation.

The outcome of olecranon and patella fractures fixed with biodegradable implants (self-reinforced poly-L-lactide wire combined with self-reinforced polyglycolide screw or self-reinforced poly-L-lactide plug) or with metallic implants (tension band wiring, Kirschner wire and metallic cerclage wire) was compared in a prospective, randomized study. Twenty-five olecranon fractures (15 with biodegradable implants and 10 with metallic ones) and 10 patella fractures (6 with biodegradable implants and 4 with metallic ones) were treated. There were no differences between these methods in outcome. Olecranon and patella fractures can be treated using biodegradable implants successfully. The total expenses are lower because a second operation is not needed to remove the implants after fracture consolidation.

Biodegradation, Environmental↗