[Our experiences with change of osteosynthesis from external fixator to internal fixation in fractures of the lower limb].
BACKGROUND
In polytrauma patients and fractures with severe soft tissue damage of the lower limb the use of external fixator is indicated. To show the possibilities and limits of change of external fixation to internal osteosynthesis we performed a retrospective analysis.


METHODS
Between 1.1.1993 to 30.6.1997 671 cases were primarily treated with external fixator. After a mean of 16.5 days a change of osteosynthesis was performed in 75 cases.


RESULTS
5 infections of the pin tracks, 3 infections of the wound, two thromboses, one case of thromboembolism and one osteomyelitis were seen in these 75 cases. One patient died due to severe brain damage after head injury. No further operations were necessary, all fractures showed primary healing. Taking the severe soft tissue damages and severe multiple trauma into account only few complications were observed.


CONCLUSIONS
The main problems and risks of internal fixation occur in the early phase of treatment, whereas complications after external fixation are more likely to occur in later stages. By a change from external fixation to internal osteosynthesis the advantages of both methods can be combined.
Schuh
A
A
Unfallchirurgische Abteilung des Klinikums Weiden.
Hausel
M
M
D000063:Accidents, Traffic; D000328:Adult; D016512:Ankle Injuries / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002111:Calcaneus / Q000293:injuries*; D016267:External Fixators; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000601:surgery; D011182:Postoperative Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000601:surgery*; D013978:Tibial Fractures / Q000601:surgery*; D013997:Time Factors
D000900:Anti-Bacterial Agents