title: Management of severe open ankle-foot trauma by a simple external fixation technique: an alternative during war and in resource-poor and low-technology environments.
abstract: Severe open foot and ankle injuries are still a challenge for the orthopaedic surgeon. Their treatment is even more difficult in third world countries and in war settings where high-energy trauma with severe soft tissue damage is more frequent. Lack of equipment, poor resources and hygiene, and different cultural systems make most of the standard proposed treatments difficult to apply. The authors describe an inexpensive, rapid, minimally invasive, and easy-to-apply external fixation technique for the treatment of severe open ankle-foot fractures. With the main goal of soft tissue management rather than definitive treatment of any bony injuries, this technique was developed over time during many consecutive missions in Sierra Leone and Afghanistan as an alternative to more appropriate treatments with surprisingly satisfactory short- and long-term results.
authors.affiliation: Emergency n.g.o. Medical Division, Milan, Italy.
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Pedrini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cardi
authors.forename: Alberto
authors.initials: A
authors.lastname: Landini
authors.forename: Gino
authors.initials: G
authors.lastname: Strada
mesh_terms: D000293:Adolescent; D000328:Adult; D000346:Afghanistan; D016512:Ankle Injuries / Q000473:pathology / Q000628:therapy*; D020811:Biomedical Technology; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D016267:External Fixators; D005260:Female; D018409:Foot Injuries / Q000473:pathology / Q000628:therapy*; D005592:Fracture Fixation / Q000379:methods*; D050723:Fractures, Bone / Q000628:therapy; D005596:Fractures, Closed / Q000473:pathology / Q000628:therapy; D005597:Fractures, Open / Q000473:pathology / Q000628:therapy*; D006295:Health Resources; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D011204:Poverty Areas; D040841:Resource Allocation / Q000379:methods*; D012807:Sierra Leone; D017695:Soft Tissue Injuries / Q000473:pathology / Q000628:therapy*; D015599:Trauma Severity Indices; D014857:Warfare; D055815:Young Adult