title: Use of a "kickstand" modification for external fixation of lower extremity fractures in children.
abstract: OBJECTIVE
  To evaluate and describe the kickstand modification and its use in children with lower extremity fractures.
  
  
  METHODS
  Retrospective review identified eight children in whom the kickstand technique was used during treatment of their lower extremity fractures. The seven boys and one girl had a mean age of 11.8 years. All fractures were caused by high-energy trauma. Five of the eight tibial fractures were open fractures (one type 1, one type 2, and three type 3B), and five of the eight patients had multiple extremity fractures.
  
  
  RESULTS
  Additional procedures were required in six of the eight children, four of whom had multiple lower extremity fractures. No additional pressure-relieving modalities were used in any patient. The kickstand did not affect the fracture reduction, prevent patient mobilization, or require operative adjustment in any patient, and none had any skin pressure-related complications on the heel of the affected extremity.
  
  
  CONCLUSIONS
  In pediatric patients with lower extremity trauma, the addition of a kickstand to the external fixator provides a simple, inexpensive, lightweight, adjustable, and adaptable method for encouraging elevation of the injured extremity, which facilitates edema control; it also allows easy neurovascular monitoring and wound care.
authors.affiliation: University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery, LeBonheur Children's Hospital, 1211 Union Avenue, Suite 510, Memphis, TN 38104 USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Sawyer
authors.forename: Derek M
authors.initials: DM
authors.lastname: Kelly
authors.forename: Leslie N
authors.initials: LN
authors.lastname: Rhodes
authors.forename: James H
authors.initials: JH
authors.lastname: Beaty
authors.forename: S
authors.initials: S
authors.lastname: Terry Canale
authors.forename: William C
authors.initials: WC
authors.lastname: Warner