Paper| Volume 26, ISSUE 4, P245-248, May 1995

External fixation as a primary and definitive treatment of open limb fractures

      This paper is only available as a PDF. To read, Please Download here.


      This paper analyses the medical records of 5024 injured persons treated and operated on at the Surgical Clinic of the Clinical Hospital in Osijek, during the war against Croatia (1991 and 1992). There were 1653 (33.0 per cent) admitted, while the rest were treated as out-patients. Of the admitted patients 82.7 per cent (1372) had limb injuries. In 760 (15.0 per cent) of the wounded, 1320 limb fractures caused by explosives were diagnosed, out of which 856 were of the lower and 464 of the upper limbs. One hundred and ninety-two (3.9 per cent) were treated by external fixation. External fixators were applied to 147 lower and 68 upper open long bones, respectively. Adequate reconstructive operations were performed on 106 (2.1 per cent) patients with associated injuries to important blood vessels. The stabilization of the open and unstable external fractures was achieved by external fixation, mostly at one level, regardless of the wound size. The importance of good wound cleaning has been particularly stressed as well as bone fragment reposition. Special attention has been given to the preoperative and intra-operative assessment of the limbs. In 20 patients (9.3 per cent) treated with external fixation, osteitis occurred. Twenty-one more patients (9.7 per cent), because of bad fracture healing after external fixation, were submitted to secondary internal bone fixation combined with bone grafts. Out of these, nine (42.8 per cent) developed osteitis as a consequence of the additional treatment.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Injury
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Davila S
        • Kušec V
        External fixation for Injuries in the War against Croatia.
        Croatían Med J. 1992; (volume-nr 33): 230
        • Huljev D
        • Rašić Ž
        • Ivanušić M
        • et al.
        External fixation of war injuries.
        Orth Traumat. 1992; 2–3: 95
        • Koržinek K
        • Smerdelj M
        • Tripković B
        Military injuries of the extremities, application of the CMC fixator.
        Liječ Vjesn. 1991; 7–8: 239
        • Oberli H
        • Frick T
        The open femoral fracture in war-173 fixateur externe utilization on the femur (Afghanistan war).
        Helv Chir Acta. 1991; 58: 687
        • Koržinek K
        • Benčić I
        • Bujanić A
        • et al.
        Kutina War Hospital.
        Orthop et Traumat. 1992; 1: 33
        • Hančević J
        • Turčić J
        • Davila S
        • et al.
        Some views on the military injuries of the locomotor system.
        Liječ Vjesn. 1991; 7–8: 257
        • Despot I
        • De Syo D
        • Vukelić M
        • et al.
        War injuries of blood vessels.
        Acta Clin Croat. 1992; 31: 159
        • Lovrić Z
        Reconstruction of major arteries of extremities after war injuries.
        J Cardiovasc Surg. 1993; 34: 33
        • Koch K
        • Knuzi W
        • von Wartburg V
        • et al.
        Injuries of the lower extremity with vascular lesions of the popliteal area. Management errors.
        Helv Chir Acta. 1991; 57: 753
        • Tonković I
        • Šoša T
        • Petrunić M
        • et al.
        Military injuries of the vessels.
        Liječ Vjesn. 1991; 7–8: 226
        • Glavina K
        • Tucak A
        • Janoši K
        • et al.
        Deliberate military destruction of the General Hospital in the City of Osijek.
        Croatian Med J. 1992; 33 (War suppl.): 61
        • Janoši K
        Organization of surgery department in Osijek in war conditions.
        Med Vjesn. 1991; 23: 93
        • Marcikić M
        • Kraus Z
        • Dmitrović B
        • et al.
        Heavy artillery attack on the pulmology ward of the Osijek General Hospital.
        Croatian Med J. 1992; : 70
        • Hančević J
        • Antoljak T
        First aid rules for the injured with and without fractures.
        Liječ Vjesn. 1991; 7–8: 259
        • Heim D
        • Marx A
        • Hees P
        • et al.
        External fixator as primary and definitive treatment of tibial fracture with severe soft tissue damage.
        Helv Chir Acta. 1991; 57: 839
        • Ryan JM
        • Cooper GJ
        • Haywood IR
        • et al.
        Field surgery on a future conventional battlefield: strategy and wound management.
        Ann R Coll Surg Engl. 1991; 73: 13
        • Fernandez Del Oca AA
        External fixation of fractures with a new frame in managing patients with multiple trauma.
        J Trauma. 1992; 32: 166
        • Komanov J
        • Nanković V
        • Gustinčic-Uzelac B
        Complication in the treatment of leg fractures by external fixator application.
        Acta Orthop Jugosl. 1986; 17 (suppl): 72
        • Scola E
        • Zwipp H
        Compartment syndrome in popliteal artery injury.
        Unfallchirung. 1991; 94: 254
        • Sabetta E
        • Burgome P
        • Pavone S
        • et al.
        Two-level fractures of the tibia: indications for surgery.
        Chir Organ Mov. 1990; 75: 121