title: Temporary and definitive external fixation of war injuries: use of a French dedicated fixator.
abstract: OBJECTIVE
  External fixation is the recommended stabilization method for both open and closed fractures of long bones in forward surgical hospitals. Specific combat surgical tactics are best performed using dedicated external fixators. The Percy Fx (Biomet) fixator was developed for this reason by the French Army Medical Service, and has been used in various theatres of operations for more than ten years.
  
  
  METHODS
  The tactics of Percy Fx (Biomet) fixator use were analysed in two different situations: for the treatment of French soldiers wounded on several battlefields and then evacuated to France and for the management of local nationals in forward medical treatment facilities in Afghanistan and Chad.
  
  
  RESULTS
  Overall 48 externals fixators were implanted on 37 French casualties; 28 frames were temporary and converted to definitive rigid frames or internal fixation after medical evacuation. The 77 Afghan patients totalled 85 external fixators, including 13 temporary frames applied in Forward Surgical Teams (FSTs) prior to their arrival at the Kabul combat support hospital. All of the 47 Chadian patients were treated in a FST with primary definitive frames because of delayed surgical management and absence of higher level of care in Chad.
  
  
  CONCLUSIONS
  Temporary frames were mostly used for French soldiers to facilitate strategic air medical evacuation following trauma damage control orthopaedic principles. Definitive rigid frames permitted achieving treatment of all types of war extremity injuries, even in poor conditions.
authors.affiliation: Clinic of Traumatology and Orthopaedics, Desgenettes Military Hospital, Lyon, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Mathieu
authors.forename: Naklan
authors.initials: N
authors.lastname: Ouattara
authors.forename: Antoine
authors.initials: A
authors.lastname: Poichotte
authors.forename: Erwan
authors.initials: E
authors.lastname: Saint-Macari
authors.forename: Olivier
authors.initials: O
authors.lastname: Barbier
authors.forename: Fréderic
authors.initials: F
authors.lastname: Rongiéras
authors.forename: Sylvain
authors.initials: S
authors.lastname: Rigal
mesh_terms: D000328:Adult; D000346:Afghanistan / Q000453:epidemiology; D002596:Chad / Q000453:epidemiology; D016267:External Fixators / Q000145:classification*; D005121:Extremities / Q000601:surgery; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods; D050723:Fractures, Bone / Q000453:epidemiology / Q000601:surgery*; D005602:France / Q000208:ethnology; D006801:Humans; D008297:Male; D008887:Military Medicine; D008889:Military Personnel; D016896:Treatment Outcome; D014857:Warfare