PURPOSE: Carrying out osteosynthesis is challenging, and controlling for results and complications is necessary to define the limits of acceptable complications. Within the context of sudden-onset disasters, comparing internal with external osteosynthesis remains controversial. METHODS: The most recent and significant Médecins Sans Frontières (MSF) experience with osteosynthesis was following the earthquake in Haiti in 2010: 353 external fixators were used in the 12 months following the catastrophe, 62 of which were used in the first month. Carrying out internal osteosynthesis was possible two weeks following the earthquake. RESULTS: The most common indication for open tibial fracture was Gustillo grade 2 or 3. Conversion rate from external to internal osteosynthesis remains anecdotal for several practical reasons. Advantages and drawbacks of external fixators are discussed in the context of precarious situations frequently encountered by MSF. CONCLUSIONS: External osteosynthesis as a primary and definitive treatment for open fractures, especially of the leg, remains the most frequently used and best-adapted procedure in the context of sudden-onset disasters, even though not ideal.
PURPOSE: Carrying out osteosynthesis is challenging, and controlling for results and complications is necessary to define the limits of acceptable complications. Within the context of sudden-onset disasters, comparing internal with external osteosynthesis remains controversial. METHODS: The most recent and significant Médecins Sans Frontières (MSF) experience with osteosynthesis was following the earthquake in Haiti in 2010: 353 external fixators were used in the 12 months following the catastrophe, 62 of which were used in the first month. Carrying out internal osteosynthesis was possible two weeks following the earthquake. RESULTS: The most common indication for open tibial fracture was Gustillo grade 2 or 3. Conversion rate from external to internal osteosynthesis remains anecdotal for several practical reasons. Advantages and drawbacks of external fixators are discussed in the context of precarious situations frequently encountered by MSF. CONCLUSIONS: External osteosynthesis as a primary and definitive treatment for open fractures, especially of the leg, remains the most frequently used and best-adapted procedure in the context of sudden-onset disasters, even though not ideal.
Authors: Mohit Bhandari; Michael Zlowodzki; Paul Tornetta; Andrew Schmidt; David C Templeman Journal: J Orthop Trauma Date: 2005-02 Impact factor: 2.512
Authors: Oscar Alvarado; Miguel Trelles; Katie Tayler-Smith; Holdine Joseph; Rodné Gesline; Thélusma Eli Wilna; Mohammad Karim Mohammad Omar; Niaz Mohammad Faiz Mohammad; John Muhima Mastaki; Richard Chingumwa Buhu; An Caluwaerts; Lynette Dominguez Journal: Int Orthop Date: 2015-05-15 Impact factor: 3.075