Iqtidar Ullah Babar1. 1. Department of Orthopaedic Surgery, PGMI, Hayatabad Medical Complex, Peshawar.
Abstract
OBJECTIVE: To evaluate the role of external fixation in the management of highly comminuted femoral shaft fractures in adults. DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Agency HQ Hospital, Landikotal and Saidu Group of Hospitals, Swat, from April 1999 to March 2002. PATIENTS AND METHODS: Fourteen adults with close Winquist Type III and IV comminuted fractures of the shaft of the femur were treated with external fixation. The fixator was applied until the fracture became stable and was followed by the application of a femoral cast-brace till consolidation. All patients were followed for a minimum period of one year after the index procedure. RESULTS: Thirteen patients (93%) achieved fracture consolidation in an average time of 5.2 months (range 4-8). Eight patients had pin-tract infections and 3 developed shortening and 11 lost an average of 34 (0-75) degrees of range-of-motion in their knees. On the basis of this loss, there were 4 excellent, 6 good, 3 fair and 1 poor result. CONCLUSION: External fixation is a useful technique for the stabilization of close comminuted femoral shaft fractures where modern technology is not available. Pin-tract infection and knee stiffness are problems inherent with the use of this method but can be easily minimized with good pin hygiene and knee exercises.
OBJECTIVE: To evaluate the role of external fixation in the management of highly comminuted femoral shaft fractures in adults. DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Agency HQ Hospital, Landikotal and Saidu Group of Hospitals, Swat, from April 1999 to March 2002. PATIENTS AND METHODS: Fourteen adults with close Winquist Type III and IV comminuted fractures of the shaft of the femur were treated with external fixation. The fixator was applied until the fracture became stable and was followed by the application of a femoral cast-brace till consolidation. All patients were followed for a minimum period of one year after the index procedure. RESULTS: Thirteen patients (93%) achieved fracture consolidation in an average time of 5.2 months (range 4-8). Eight patients had pin-tract infections and 3 developed shortening and 11 lost an average of 34 (0-75) degrees of range-of-motion in their knees. On the basis of this loss, there were 4 excellent, 6 good, 3 fair and 1 poor result. CONCLUSION: External fixation is a useful technique for the stabilization of close comminuted femoral shaft fractures where modern technology is not available. Pin-tract infection and knee stiffness are problems inherent with the use of this method but can be easily minimized with good pin hygiene and knee exercises.