External fixation maintained until fracture consolidation in the skeletally immature.

In a prospective study, we investigated the effects of external fixation on fracture union in skeletally immature patients. Twenty-five fractures of the femur and tibia in 21 patients were fixed externally with the intention of leaving the fixator in place until the fractures consolidated or nonunion was established. The main indications were head injury and multiple trauma. One hundred percent of the fractures consolidated with the fixator in place; 45 of 50 joints had 100% motion, three had 95% motion, and two had 60% motion owing to scarring from traumatic wounds. Eight-four percent of the fractures lost no position in the fixator, and 16% lost < or = 5 degrees.