The Use of External Fixators in the Polytraumatized Patient

  • B. F. Claudi
  • V. Mooney
Conference paper


Application of external fixators in the management of severe fractures has become an important part in the management of polytraumatized patients. Parallel to the development and presentation of new external fixators during recent years we have been confronted with numerous publications on where and how these fixators might be used. Over the past years, it has been increasingly accepted that the corrent application of external fixators requires a sound understanding of the mechanical characteristics of these devices; furthermore, it became obvious, mainly following a number of disappointing clinical results, that masterful skills in surgical techniques are absolutely essential. As demonstrated best by workshops on external fixators held during the last three years in North America, this issue has become very complicated for the majority of common orthopedic surgeons, and even confusing with regard to the basic mechanical data available about biomechanical results. How can highly specialized knowledge of a small aspect match the needs for a sound integrated knowledge of the various problems in the management of a polytraumatized patient? Some of us have found an answer to that question in that we try to escape involvement in the emotionally exhausting treatment of multiple — injured patients. The others who must share the responsibilities for the treatment of these patients are frequently confused, particularly when reading recent publications on indications for external fixators stressing the fact that there is nowadays almost no skeletal part which cannot be successfully managed by external devices. This, we believe, implies a risky management of musculoskeletal injuries in polytraumatized patients, since opportunities for definitive and appropriate fracture fixation often will be missed.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Boltze, W. H., Fernandez, D. L., and Schatzker, J.: The External Fixator (Tubular System). AO-Bulletin, November 1976, Bern.Google Scholar
  2. 2.
    Brooker, A. F., Jr.: The use of external fixation in the treatment of burn patients with fractures. In, External Fixation: The Current State of the Art. Williams & Wilkins, Baltimore/London, 1979. pp. 225–237.Google Scholar
  3. 3.
    Claudi, B., Rittmann, W. W., and Ruedi, Th.: Anwendung des Fixateur externe bei der Primaerversorgung offener Frakturen. Helv. Chir. Acta 43, 469, 1976.PubMedGoogle Scholar
  4. 4.
    Edwards, Charles C.: Management of the polytrauma patient in a major U. S. center. In, External Fixation: The Current State of the Art, Williams & Wilkins, Baltimore/London, 1979. pp 181–201.Google Scholar
  5. 5.
    Hoffmann, R.: L’ostéotaxis: Ostéosynthèse transcutanée par fiches et rotules. Gead, Paris, 1951.Google Scholar
  6. 6.
    Hierholzer, G.: Stabilisierung des Knochenbruchs beim Weichteilschaden mit Fixateurs externe. Langenbecks Arch. Chir. 339, 505, 1975.PubMedCrossRefGoogle Scholar
  7. 7.
    Mears, D. C., and Fu, F. H.: Modern concepts of external skeletal fixation of the pelvis. Clin. Orthop. 151, 65, 1980.PubMedGoogle Scholar
  8. 8.
    Pfister, U.: Fixateur externe bei Arthrodesen. Akt. traurnatologie 6, 91, 1976.Google Scholar
  9. 9.
    Slätis, P., and Karharju, E. O.: External fixation of the pelvic girdle with a trapezoid frame. Injury 7, 53, 1975.PubMedCrossRefGoogle Scholar
  10. 10.
    Tile, M., and Pennal, G. F.: Pelvic disruption: Principles of management. Clin. Orthop. 151, 56, 1980.PubMedGoogle Scholar
  11. 11.
    Trentz, O.: Notversorgung von frischen Verletzungen mit dem Fixateur externe. Akt. traurnatologie 6, 76, 1976.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1982

Authors and Affiliations

  • B. F. Claudi
  • V. Mooney

There are no affiliations available

Personalised recommendations