title: Use of the ring fixator in the treatment of fractures of the lower extremity in long-term paraplegic and tetraplegic patients.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To examine the value of operative fracture stabilization by means of the ring fixator in fractures of the lower extremity in the presence of chronic paralysis caused by transverse lesions of the spinal cord.
  
  
  METHODS
  A specialist center for the treatment of spinal cord injuries in Germany.
  
  
  METHODS
  Clinical examination of the lower extremities with side-for-side comparison, radiological investigation of the fractures, patient survey.
  
  
  METHODS
  In 21 patients with chronic spinal cord lesions, 22 fractures of the lower extremities were treated with the ring fixator.
  
  
  RESULTS
  At follow-up a mean of 41.5 months after fracture healing it could be shown that movement in the knee and ankle joints on the same side as the fracture was not restricted by more than 10 degrees in any of our patients. No losses affecting activities of daily living were reported, and 19 of the 21 patients were satisfied with the result achieved with this technique. After four of the 22 operations there were complications. Malalignments were visible radiologically following five of the fractures.
  
  
  CONCLUSIONS
  In osteoporosis-induced fractures of the lower extremities in chronically paraplegic and tetraplegic patients, fracture stabilization with the ring fixator, with fewer complications and better results in terms of joint mobility, is superior to the conservative treatment so far given preference in the literature. It should be offered as an alternative to conservative treatment in the case of pathological fractures.
authors.affiliation: Spinal Cord Center, Werner Wicker Clinic, 34537 Bad Wildungen, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Meiners
authors.forename: M
authors.initials: M
authors.lastname: Keil
authors.forename: R
authors.initials: R
authors.lastname: Flieger
authors.forename: R
authors.initials: R
authors.lastname: Abel
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011782:Quadriplegia / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*