Treatment of open fractures with a computer-assisted external fixator system without the use of fluoroscopy.
BACKGROUND
Developed for the treatment of deformity correction, computer-assisted circular external fixators in recent years have also been used for fracture fixation. In this study, we aimed to present the efficacy of computer-assisted circular external fixator use in open long bone fractures with our new technique.


METHODS
Between February 2013 and June 2014, 14 patients (mean age 24.5 (range 20-32)) with open tibial or femoral open fractures were treated with the computer-assisted fixation system (Spider Frame-Tasarım Medikal, Istanbul, Turkey). In all patients, appropriate positions of the rings and Schanz screws were determined by measurements on preoperative radiographs. The length of the Schanz screws were determined by depth measure marks on drill bits. Obvious deformities were corrected intraoperatively by manipulations, but residual deformities were corrected by a software program (Spiderfix, Tasarım Medikal, Istanbul, Turkey). We did not use fluoroscopy during the procedures.


RESULTS
Ten patients had tibia diaphyseal and four patients had femoral diaphyseal fractures. Mean surgical time was 24.2 (range 18-28) min. Average follow-up time was 10.2 (range 9-14) months. Mean time for deformity correction was 3.1 (2-5) days. Complete union was observed in all patients with a mean of 4.9 (range 3-9) months. There were two grade 2 pin site infections treated with oral antibiotherapy and pin site care. We did not detect any Schanz screw breakage, loosening, deep infection, nonunion, or malunion.


CONCLUSIONS
Computer-assisted external fixation systems can be used in the treatment of open fractures, and they provide the chance for acute or gradual correction. Preoperative planning and assistant devices with depth measures may decrease the procedure time and the need for fluoroscopy use.
Department of Orthopaedics and Traumatology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey.
Adnan
A
Kara
Department of Orthopaedics and Traumatology, Zonguldak Ataturk State Hospital, Tepebası Mah, Kapuz Cad. Turkuaz apt. No: 28/10, 67030, Zonguldak, Turkey. drhalukcelik@gmail.com.
Haluk
H
Celik
Department of Orthopaedics and Traumatology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey.
Ali
A
Seker
Faculty of Medicine, Department of Orthopaedics and Traumatology, Namık Kemal University, Tekirdag, Turkey.
Ozgur
O
Karakoyun
Department of Orthopaedics and Traumatology, Sisli Hamidiye Etfal Research Hospital, Istanbul, Turkey.
Raffi
R
Armagan
Department of Orthopaedics and Traumatology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey.
Ersin
E
Kuyucu
Department of Orthopaedics and Traumatology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey.
Mehmet
M
Erdil
D000328:Adult; D016267:External Fixators; D005264:Femoral Fractures / Q000601:surgery*; D005471:Fluoroscopy; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods; D017102:Fracture Healing; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011182:Postoperative Care / Q000379:methods; D011859:Radiography; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
Circular external fixators; Computer-assisted circular external fixators; Fluoroscopy; Open fracture treatment