title: [Management of unstable shaft fractures of the lower extremity in children using the external fixator].
abstract: METHODS
  Since 1993 we have treated 30 children between 2 and 15 years with 31 unstable tibial and femoral shaft fractures. We perform closed reduction und X-ray control and stabilize the fracture using the monotube-fixator, system Howmedica. The advantages of this system are based on the self-drilling, self-cutting screws and the simple dynamization.
  
  
  CONCLUSIONS
  The treatment of dislocated, instable fractures of the tibial and femoral shaft in children using traction method is related with a long hospital stay in an uncomfortable position. The traction method leads to bone healing, but with a high rate of deformity after reposition. We treat the shaft fractures of the lower extremity using the external fixation. This method allows to reach early weight bearing mobilisation, it is related to a shorter hospital stay. The child is already one day after initial treatment allowed to walk with full weight bearing. The treatment with the external fixation is a modification of the traction method.
  
  
  CONCLUSIONS
  We think to have a good concept of treatment using external fixation in children with unstable fractures of the femur and tibia shaft. The disadvantages namely pin tract infections, general anesthesia for removal and difficulties with the reduction are overruled by the advantages as short hospital stay, early weight bearing mobilisation and early return of the child to his own environment.
authors.affiliation: Chirurgische Klinik, Kantonsspital Winterthur.
authors.forename: A
authors.initials: A
authors.lastname: Platz
authors.forename: K
authors.initials: K
authors.lastname: Käch
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004434:Early Ambulation; D016267:External Fixators; D005260:Female; D005264:Femoral Fractures / Q000628:therapy*; D006801:Humans; D007902:Length of Stay; D008297:Male; D013978:Tibial Fractures / Q000628:therapy*