Highlights
-
Temporary bridging trans-hip external fixation, what spans the hip joint, is recommended as primary skeletal stabilization in complex intraarticular, periarticular fractures or extensive peri-articular soft-tissue damage caused by war trauma.
ABSTRACT
The role of external fixation in Damage Control Orthopaedics has been well described.
Temporary external fixation has been recommended to provide relative bone stability
while the soft tissue heals, prior to formal open reduction and internal fixation.
Temporary bridging external fixation, that spans the joint, is recommended as primary
skeletal stabilization in complex intra-articular and peri-articular fractures, in
extensive peri-articular soft-tissue damage around the knee, ankle, elbow and wrist
joints. Works devoted to temporary trans-hip external fixation in treatment of complex
high-energy injuries are relatively rare.
The purpose of this article is to present our experience in using temporary hip spanning
external fixation during primary treatment of six patients suffered from complex open
intra-articular and peri-articular fractures of the proximal femoral bone with extensive
soft tissue damage due to war blast or high-velocity gunshot trauma. Primary management
was based on the concept of Advanced Trauma Life Support and Damage Control Orthopaedics.
Conversion to definitive bone reconstruction was performed on the next stage of the
treatment after general and local stabilization.
Key words
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 accessOne-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:
Subscribe to InjuryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Temporary external fixation for the management of complex intra- and periarticular fractures of the lower extremity.J Orthop Trauma. 2002; 16: 678-685
- External fixation and temporary stabilization of femoral and tibial trauma.J Surg Orthop Adv. 2011; 20: 74-81
- Military limb injuries/ballistic fractures.Current Orthopaedics. 2006; 20: 346-353
- Conversion from external fixation to definitive fixation: periarticular injuries.J Am Acad Orthop Surg. 2006; 14: 128-130
- Open comminuted femoral fractures.in: Zarka S Lerner A Complicated War Trauma and Care of the Wounded. Springer International Publishing AG, Switzerland2017: 77-79
- Pelvifemoral external fixation for the treatment of open fractures of the proximal femur caused by firearms.Acta Orthop Belg. 2002; 68: 37-41
- Primary skeletal stabilization and role of external fixation.Orthopedics in Disasters. Orthopedic Injuries in Natural Disasters and Mass Casualty Events. 2016; : 227-228
- Primary external fixation.in: Lerner A Soundry M Armed Conflict Injuries to the Extremities. A treatment manual. Springer-Verlag, Berlin, Heidelberg2011: 133-147
- External fixator.AO principles of fracture management. 2017; : 263
- The price of peace: The personal and financial cost of paramilitary punishments in Northern Ireland.Injury. 2003; 1: 41-45
- Is staged external fixation a valuable strategy for war injuries to the limbs?.Clin Orthop Relat Res. 2006; 448: 217-224
- Mid-term outcome of patients with pelvic and acetabular fractures following internal fixation through a modified Stoppa approach.Acta Orthop Belg. 2013; 79: 660-666
- Early fixation strategies for high energy pelvic ring injuries – the Zurich algorithm.Injury. 2021; 52: 2712-2718
- Time to think outside the box: ‘PRompt-Individualised-Safe Management’ (PR.I.S.M.) should prevail in patients with multiple injuries.Injury. 2017; 48: 1279-1282
- Limb Salvage and Reconstruction.in: Anderson PA Browner BD Krettek C Jupiter BJ Skeletal Trauma: Basic Science, Management, and Reconstruction. 6th edition. Elsevier-Health Sciences Division, 2020: 2788-2804
- Placement of half-pins for supra-acetabular external fixation: an anatomic study.Clin Orthop Relat Res. 2003; 411: 269-273
Article info
Publication history
Published online: January 03, 2023
Accepted:
January 2,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
