[Primary external fixation with consecutive procedural modification in polytrauma].
OBJECTIVE
It is the purpose of the current investigation to determine whether immediate external fixation of fractures, which is a simple and fast procedure, followed by secondary planned conversion represents a safe and reliable procedure without additional trauma in multiply injured patients (ISS > 15).


METHODS
With a prospective protocol, all data of multiply injured patients with fractures which required immediate osteosynthesis were registrated. Demographic data, severity of injury (AIS and ISS), data of primary surgery and osteosyntheses, course of intensive care (organ failure, local/systemic complications, infectious protocol), secondary conversion (time, duration, osteosynthesis related complications) and further course were analysed.


RESULTS
Out of 679 mulitiply injured patients (ISS 22), 118 required immediate surgical procedures for intracranial injury and 175 for further indications. In 45 multiply injured patients (ISS 37), 83 external fixations were performed. According to 59 planned secondary conversions (13 days), one patient developed deep infection, no other local complication was registrated. The average time for conversion procedures lasted three times longer as in immediate external fixation (43 vs. 139 min).


CONCLUSIONS
Immediate external fixation in multiply injured patients is fast and poor of complications. It is a expedient procedure which is safe and careful for critically ill patients. The required conversion procedure shows no raised rate of complications.
Taeger
G
G
Klinik und Poliklinik für Unfallchirurgie, Universität Essen, Hufelandstrasse 55, 45122 Essen. georg.taeger@uni-essen.de
Ruchholtz
S
S
Zettl
R
R
Waydhas
C
C
Nast-Kolb
D
D
D000293:Adolescent; D000328:Adult; D020878:Device Removal; D004636:Emergency Service, Hospital; D016267:External Fixators; D005260:Female; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000601:surgery*; D010043:Outcome and Process Assessment, Health Care; D012086:Reoperation
Primärer Fixateur externe mit konsekutivem Verfahrenswechsel beim Polytrauma.