title: Prolonged femoral external fixation after natural disaster: successful late conversion to intramedullary nail aboard the USNS Mercy hospital ship.
abstract: After the 9.0 magnitude earthquake and tsunami of December 26, 2004, orthopaedic injuries were a major healthcare problem in parts of South East Asia. We report our late encounter with an Indonesian patient treated acutely with external fixation of a femur fracture. We describe our procedure for conversion of prolonged external fixation (59 days) to an intramedullary nail (IMN) aboard the USNS Mercy and provide two-year follow-up. A review of current literature on conversion of femoral external fixation to IMN is included. This report highlights the potential pitfalls of external fixation of femur fractures in an austere post-natural disaster environment where orthopaedic follow-up care may be delayed or nonexistent.
authors.affiliation: Department of Orthopaedic Surgery, Naval Medical Center San Diego, California, USA.
authors.forename: V Franklin
authors.initials: VF
authors.lastname: Sechriest
authors.forename: David W
authors.initials: DW
authors.lastname: Lhowe
mesh_terms: D000293:Adolescent; D055866:Earthquakes; D016267:External Fixators / Q000009:adverse effects*; D005264:Femoral Fractures / Q000150:complications / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D008297:Male; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery