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External Fixator as an Augment or Alternative to an Internal Fixator

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Handbook of Orthopaedic Trauma Implantology

Abstract

It is very difficult to categorize whether external fixator serves the purpose of replacement of internal fixation or it acts as an augmentation of internal fixation because in difficult orthopaedic conditions it is helpful for both situations. For fixation of compound fractures with severe soft tissue damage and infected and gap non-union where bone transportation is mandatory, external fixation is the implant of choice and acts as a replacement of internal fixator. On the contrary severe comminuted epiphyseal fractures involving the articular surface temporary application of external fixator to achieve the reduction followed by internal fixation with appropriate implant is the treatment of choice. For correction of malunited fracture leading to deformity and shortening either as acute procedure or delayed procedure, external fixators can be used as an augment of internal fixator.

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References

  1. Azar FM, Canale ST, Beaty JH. Campbell’s operative orthopaedics. 13th ed. Elsevier Inc.

    Google Scholar 

  2. McQueen MM. Non-spanning external fixation of the distal radius. Hand clinics. 2005;21(3):375–80. https://doi.org/10.1016/j.hcl.2005.04.006.

    Article  PubMed  Google Scholar 

  3. Pape HC, Torentte P 3rd, Tarkin I, et al. Timing of fracture fixation in multi trauma patient the role of early total care and damage control surgery. Acad Orthop Surg. 2009;17:541.

    Article  Google Scholar 

  4. Malhotra AK, Goldberg S, et al. Open extremity fracture impact of delay inoperative debridement and irrigation. J Trauma Acute Care Surg. 2014;76:1201.

    Article  PubMed  Google Scholar 

  5. Beltsios M, Savvidou O, Kovanis J, Alexandropoulos P, Papagelopoulos P. External fixation as a primary and definitive treatment of tibial diaphyseal fracture. Strateg Trauma Limb Reconstr. 2009;4(2):81–7.

    Article  Google Scholar 

  6. Melendez EM, Colon C. Treatment of open tibial fracture with Orthofix fixator. Clin Orthop Relat Res. 1989;241:224–30.

    Article  Google Scholar 

  7. Nahouli H, Masrouha K, et al. The impact of radiographic parameters and bone grafting at the docking site on union following bone transport for segmental bone defects of the tibia and the femur: a retrospective cohort pilot study. J Limb Lengthen Reconstr. 2020;6:33–9.

    Article  Google Scholar 

  8. Paley D, Catagni MA, Argnani F, Villa A, Benedetti GB, Cattaneo R. Ilizarov treatment of tibial nonunions with bone loss. Clin Orthop Relat Res. 1989;241:146–65.

    Article  Google Scholar 

  9. Mudiganty S, Daolagupu AK, Sipani AK, Das SK, Dhar A, Gogoi PJ. Treatment of infected non-unions with segmental defects with a rail fixation system. Strateg Trauma Limb Reconstr. 2017;12(1):45–51. https://doi.org/10.1007/s11751-017-0278-6. Epub 2017 Feb 24. PMID: 28236034; PMCID: PMC5360676.

  10. Lakhani A, Singh D, Singh R. Outcome of rail fixator system in reconstructing bone gap. Indian J Orthop. 2014;48(6):612–6.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Zeman J, Matejka J. Use of a hybrid external fixator for treatment of tibial fractures. Acta Chir Orthop Traumatol Cech (In Czech). 2005;72(6):337–43.

    CAS  Google Scholar 

  12. Goel S, Elhence A. Ankle spanning external fixator with limited internal fixation for distal tibia extra articular fracture. Int J Res Med Sci. 2017;5:4355–9.

    Article  Google Scholar 

  13. Paley D, Herzenberg JE, Bor N. Fixator-Assisted nailing of femoral and tibial deformities. Tech Orthop. 1997;12(4):260–75.

    Article  Google Scholar 

  14. Kovar FM, Jauregui JJ, Herzenberg JE. Accuracy of distal femoral valgus deformity correction with fixator assisted nailing vs. fixator assisted locked plate. Am J Orthop. 2018;47(6).

    Google Scholar 

  15. Rozburch RS. Fixator assisted plating in limb deformities. Oper Tech Orthop. 2011;21:174–9. Elsevier.

    Google Scholar 

  16. Chaudhury M. Limb lengthening over nail can safely reduce the duration of external fixator. Indian J Orthop. 2008;42(3):323–9.

    Google Scholar 

  17. Paley D, Herzenberg JE, Paremain G, Bhave A. Femoral lengthening over an intramedullary nail. A matched-case comparison with Ilizarov femoral lengthening. J Bone Joint Surg Am. 1997;79:1464–80.

    Article  CAS  PubMed  Google Scholar 

  18. Tosun HB, Serbest S, Uludag A, Gumustas S, Celik S. Fixator-assisted tibial lengthening over a plate in a patient with sequelae of poliomyelitis. Medicine (Baltimore). 2016;95(44):e5252.

    Article  PubMed  Google Scholar 

  19. Skomoroshko PV, Vilensky VA, et al. Mechanical rigidity of the Ortho-SUV frame compared to the Ilizarov frame in the correction of femoral deformity. Strateg Trauma Limb Reconstr. 2015;10:5–11. https://doi.org/10.1007/s11751-015-0214-6.

    Article  Google Scholar 

  20. Wagner P, Burghardt RD, Green SA, Specht SC, Standard SC, Herzenberg JE. PRECICE magnetically-driven, telescopic, intramedullary lengthening nail: pre-clinical testing and first 30 patients. SICOT J. 2017;3:19. EDP Sciences. https://doi.org/10.1051/sicotj/2016048.

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Basu, S. (2023). External Fixator as an Augment or Alternative to an Internal Fixator. In: Banerjee, A., Biberthaler, P., Shanmugasundaram, S. (eds) Handbook of Orthopaedic Trauma Implantology. Springer, Singapore. https://doi.org/10.1007/978-981-19-7540-0_19

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  • DOI: https://doi.org/10.1007/978-981-19-7540-0_19

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-7539-4

  • Online ISBN: 978-981-19-7540-0

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