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Temporary bridging trans-hip external fixation in damage control orthopaedics treatment after severe combat trauma: A clinical case series

  • Alexander Lerner
    Affiliations
    Department of Orthopaedics, Riga Stradins University, 22 Duntes Str., Riga, LV-1005, Latvia

    Department of Orthopaedic Surgery, Ziv Medical Center, P.o.b. 1008, Zefat, Israel

    Orthopaedic Department, Azrieli Faculty of Medicine, Bar-Ilan University, Henrietta Szold 8, Zefat, Israel
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  • Ruta Jakusonoka
    Correspondence
    Correspondence: Ruta Jakusonoka, address: Department of Orthopaedics, Riga Stradins University, 22 Duntes Street, Riga, LV-1005, Latvia; cellular phone: +371 29162563
    Affiliations
    Department of Orthopaedics, Riga Stradins University, 22 Duntes Str., Riga, LV-1005, Latvia
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  • Andris Jumtins
    Affiliations
    Department of Orthopaedics, Riga Stradins University, 22 Duntes Str., Riga, LV-1005, Latvia
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  • David Rothem
    Affiliations
    Department of Orthopaedic Surgery, Ziv Medical Center, P.o.b. 1008, Zefat, Israel

    Orthopaedic Department, Azrieli Faculty of Medicine, Bar-Ilan University, Henrietta Szold 8, Zefat, Israel
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Published:January 03, 2023DOI:https://doi.org/10.1016/j.injury.2023.01.007

      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

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