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PubMed1988

[The tibio-calcaneus external fixator in the treatment of fractures of the lower tibia].

Twenty-seven patients with complex fractures of the lower end of the tibia were treated by an external Hoffman fixator between 1977 and 1981. Its use was inspired by the presence of skin lesions and by the anatomical type of fracture when it was felt that other methods of treatment would be ineffective or hazardous. In favour of the method was the absence of iatrogenic infection and anatomical results that were superior to those of conservative treatment. Against it, there was a longer time for union, with eight delayed unions and three non-unions and the fact that it was impossible to correct joint impaction which was present in 14 out of 28 cases.

Adolescent↗
PubMed1997

Dynamic external fixation for distal radius fractures.

Thirty adult patients with closed comminuted and mostly intraarticular fractures of the distal radius were treated by closed reduction and immobilization with a dynamic external wrist fixator during a 2-year period. In 13 patients with severely comminuted and unstable fractures, additional Kirschner wires were used. After 10 to 14 days of rigid fixation in neutral position, the motion element was unlocked to allow up to 30 degrees flexion. Six weeks later, the fixator was removed. The patients then were observed for an average of 24 weeks. An excellent functional outcome was seen in 6 patients (20%), a good outcome in 20 patients (67%), and a fair outcome in 4 patients (13%). Anatomically, 15 patients (50%) had an excellent result, 14 (47%) a good outcome, and 1 (3%) a fair outcome. Only minimal loss of reduction averaging 1 degree palmar tilt was seen during mobilization. There were 2 major complications: 1 deep Kirschner wire tract infection and 1 index metacarpal fracture. Minor complications such as sensory disturbances and pin tenderness were present but recovered completely after removal of the fixator. This study provides promising data and offers an alternative method in the treatment of distal radius fractures with severe comminution. In cases with postreductive unstable fragments, additional Kirschner wires should be used to allow early mobilization of the wrist.

Adult↗