title: Circular external fixation for treatment of distal humerus fractures: case report.
abstract: High-energy blasts can lead to complex intra-articular distal humerus fractures with extensive soft tissue loss, and treatment is fraught with complications. We describe 2 patients with such injuries treated successfully with the use of aggressive wound management followed by distal humerus fracture stabilization with a circular external fixator. We chose this circular external fixator over the Ilizarov frame because of our experience and success in the treatment of open tibia fractures with negligible malalignment and high union rate. This circular external fixator allows for indirect reduction of fracture fragments over time to improve final alignment with great control to fine-tune the reduction postoperatively. In our humerus cases, fracture union was achieved with good alignment and acceptable functional range of motion. Symptomatic heterotopic ossification did not develop despite the presence of multiple risk factors.
authors.affiliation: Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA. Louis.R.Lewandowski.mil@health.mil
authors.forename: Louis
authors.initials: L
authors.lastname: Lewandowski
authors.forename: Scott M
authors.initials: SM
authors.lastname: Tintle
authors.forename: Carl
authors.initials: C
authors.lastname: Daniel
authors.forename: Joseph A
authors.initials: JA
authors.lastname: O'Daniel
authors.forename: Mark
authors.initials: M
authors.lastname: Fleming
authors.forename: John
authors.initials: J
authors.lastname: Keeling
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000601:surgery*; D006259:Craniocerebral Trauma / Q000601:surgery; D003646:Debridement; D016267:External Fixators; D005592:Fracture Fixation / Q000379:methods*; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D057072:Intra-Articular Fractures / Q000601:surgery*; D008297:Male; D009104:Multiple Trauma / Q000601:surgery; D011859:Radiography; D000070599:Shoulder Injuries; D017695:Soft Tissue Injuries / Q000601:surgery; D055815:Young Adult; D000092464:Elbow Injuries