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Definitive Bone Fixation and Reconstruction: Conversion from Temporary External Fixation to Internal Fixation Methods

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Armed Conflict Injuries to the Extremities

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Abstract

Temporary external fixation is frequently employed in the military combat theater of operations to temporize devastating extremity injuries and facilitate transport of the wounded soldier. Multiple civilian and a few military studies have provided helpful insight into the staged treatment of these injuries including conversion of temporary external fixation to definitive stabilization with internal fixation. Diaphyseal fractures of the long bones are often converted to intramedullary devices and less frequently to plate fixation, “built-up” external fixators, or ring fixators. Periarticular fractures are converted to formal open reduction and internal fixation, hybrid, or ring fixators depending on surgeon preference. Reconstructive protocols call for stringent evaluation of the preexisting pin tracts and a stable soft-tissue envelope prior to proceeding with conversion, usually within a window of 1–2 weeks. A still undefined safety interval that may approximate 3 weeks between fixator removal and intramedullary nailing can be employed when there has been a history of pin-tract infection.

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Author information

Authors and Affiliations

  1. Orthopaedic Trauma Service, Orthopaedic Specialty Center, 192 Tilley Drive, South Burlington, VT, 05403, USA

    Craig S. Bartlett III

  2. Department of Orthopaedics and Rehabilitation, University of Vermont, Stafford Hall, 95 Carrigan Drive, VT, 05405-0084, Burlington, USA

    Benjamin Geer

  3. Orthopaedic Trauma Service, The Hospital For Special Surgery, 120 East End Ave, Apt 5C, New York, NY, 10021, USA

    David L. Helfet

Authors
  1. Craig S. Bartlett III
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  2. Benjamin Geer
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  3. David L. Helfet
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Correspondence to Craig S. Bartlett III .

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Editors and Affiliations

  1. Ziv Medical Center, Str. Rambam 1, Zefat, 13100, Israel

    Alexander Lerner

  2. Faculty of Medicine, Deptartment of Orthopaedic Surgery, Rambam Medical Center, Haaliyah Street 8, Haifa, 31096, Israel

    Michael Soudry

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Bartlett, C.S., Geer, B., Helfet, D.L. (2011). Definitive Bone Fixation and Reconstruction: Conversion from Temporary External Fixation to Internal Fixation Methods. In: Lerner, A., Soudry, M. (eds) Armed Conflict Injuries to the Extremities. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-16155-1_14

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  • DOI: https://doi.org/10.1007/978-3-642-16155-1_14

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  • Publisher Name: Springer, Berlin, Heidelberg

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  • Online ISBN: 978-3-642-16155-1

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