Open Access, Peer-reviewed, Quarterly
pISSN 1225-1682
eISSN 2287-9293
    J Korean Fract Soc. 2013 Apr;26(2):164-169. Korean.
    Published online Apr 22, 2013.
    https://doi.org/10.12671/jkfs.2013.26.2.164
    Copyright © 2013 The Korean Fracture Society
    Review

    Selection and Recommended Usage Guide of Temporary External Fixator

    Seung-Jae Lim, M.D., Ph.D., Ki-Sun Sung, M.D., Ph.D. and Chang-Wug Oh, M.D., Ph.D.*
      • Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
      • *Department of Orthopedic Surgery, Kyungpook National University Hospital, Kyungpook National University Medical School, Daegu, Korea.
    • Address reprint requests to: Seung-Jae Lim, M.D., Ph.D. Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. Tel: 82-2-3410-3509, Fax: 82-2-3410-0061, Email: limsj@skku.edu

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Figures

    Fig. 1
    (A) A 19-year-old female patient was referred to our hospital with proximal tibial segmental fracture spanned with a knee-spanning external fixator.

    (B) Poorly placed tibial pins violating future incision area for internal fixation, as well as providing no stability to the tibial shaft fracture. Mild ischemic changes were also noted due to compromised blood supply.

    (C, D) After converting to plating, deep infection developed at the original half pin site, finally resulting in osteomyelitis.

    Fig. 2
    (A) A 59-year-old female patient was referred to our hospital with open distal femoral comminuted fracture stabilized with a knee-spanning frame. Anterior femoral pins were placed away from anticipated lateral incision, but overlapped with planned plating position.

    (B) Pin site debridement was performed along with administration of antibiotics for 1 week, and then definitive surgery was performed.

    (C) One year after surgery, union was obtained with no sign of infection.

    Fig. 3
    (A) Tibial plateau fracture was stabilized with a knee-spanning external fixator after a single incision fasciotomy.

    (B) Note the placement of lateral femoral pins to avoid violating quadriceps mechanism. At 14 days, the fracture was stabilized with minimally invasive percutaneous plating.

    (C) One year after surgery, union was obtained with no sign of infection.

    Fig. 4
    (A) A 53-year-old female patient sustaining a comminuted tibial pilon fracture.

    (B) She was treated acutely with open plating of comminuted fibular fracture and an ankle-spanning monolateral external fixator.

    (C) Tibial pilon fracture was stabilized with percutaneous medial plating and healed with no infection or wound problem at 1 year after the surgery.

    Fig. 5
    (A) A 69-year-old female patient sustaining a tibial pilon fracture with hemorrhagic fracture blisters.

    (B) The fracture was stabilized with an ankle-spanning external fixator of delta configuration.

    (C) After healing of soft tissue at 14 days, definitive stabilization was performed with open plating for fibular fracture and percutaneous medial plating for tibial pilon fracture.

    Tables

    Table 1
    Indications for Temporary External Fixation

    References

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      1. Patterson MJ, Cole JD. Two-staged delayed open reduction and internal fixation of severe pilon fractures. J Orthop Trauma 1999;13:85–91.
      1. Phisitkul P, McKinley TO, Nepola JV, Marsh JL. Complications of locking plate fixation in complex proximal tibia injuries. J Orthop Trauma 2007;21:83–91.
      1. Sirkin M, Sanders R, DiPasquale T, Herscovici D Jr. A staged protocol for soft tissue management in the treatment of complex pilon fractures. J Orthop Trauma 2004;18:S32–S38.
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    MeSH Terms
    External Fixators
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