title: External fixation for severe open fractures of the humerus caused by missiles.
abstract: OBJECTIVE
  To evaluate the use of external fixation of the humerus after missile injuries.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  University medical center.
  
  
  METHODS
  Twenty-six soldiers with twenty-six open Gustilo type III fractures.
  
  
  METHODS
  Immediate external fixation.
  
  
  METHODS
  Clinical, functional, social, and rehabilitation criteria were evaluated.
  
  
  RESULTS
  Excellent in fourteen patients (61%), good in four (17%), fair in three (13%), and poor in two (9%). All fractures eventually healed.
  
  
  CONCLUSIONS
  External fixation is the preferred initial treatment for stabilizing severe open missile fractures of the humerus. Its use, together with radical debridement of dead bone, has reduced the incidence of chronic infection and improved the prognosis of vascular repairs. As a result, the rate of morbidity and upper limb amputation has been reduced significantly, compared with our previous experience.
authors.affiliation: Department of Orthopaedics and Traumatology B', Rambam Medical Center, Haifa, Israel.
authors.forename: C
authors.initials: C
authors.lastname: Zinman
authors.forename: D
authors.initials: D
authors.lastname: Norman
authors.forename: K
authors.initials: K
authors.lastname: Hamoud
authors.forename: N D
authors.initials: ND
authors.lastname: Reis
mesh_terms: D000328:Adult; D016267:External Fixators; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D015601:Injury Severity Score; D007557:Israel; D008297:Male; D008889:Military Personnel; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000601:surgery*