Advertisement

Complications of External Fixation

Chapter

Abstract

External fixation has assumed an important role in damage control orthopedics. Common indications include open fractures, bridging juxta-articular fractures or dislocations, and pelvic external fixation. Complications may ensue from external fixation as with other surgical treatment. It is important for the surgeon to be aware of these potential complications and to manage them appropriately to achieve a successful outcome.

Keywords

Fracture Healing External Fixation Intramedullary Nailing Femoral Shaft Fracture External Frame 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Chao EY, Kasman RA, An KN. Rigidity and stress analyses of external fracture fixation devices – a theoretical approach. J Biomech. 1982;15(12):971–83.PubMedCrossRefGoogle Scholar
  2. 2.
    Pettine KA, Chao EY, Kelly PJ. Analysis of the external fixator pin-bone interface. Clin Orthop Relat Res. 1993;Aug;(293):18–27. J Trauma. 2001(Jun);50(6):1008–14.Google Scholar
  3. 3.
    Checketts RG, MacEachern AG, Otterburn M. Pin track infection and the principles of pin site care. In: De Bastiani A, Graham Apley A, Goldberg A, editors. Orthofix external fixation in trauma and orthopaedics. Berlin/Heidelberg/New York: Springer; 2000. p. 97–103.CrossRefGoogle Scholar
  4. 4.
    Gordon JE, Kelly-Hahn J, Carpenter CJ, Schoenecker PL. Pin site care during external fixation in children: results of a nihilistic approach. J Pediatr Orthop. 2000;20(2):163–5.PubMedCrossRefGoogle Scholar
  5. 5.
    W-Dahl A, Toksvig-Larsen S, Lindstrand A. No difference between daily and weekly pin site care: a randomized study of 50 patients with external fixation. Acta Orthop Scand. 2003;74(6):704–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Temple J, Santy J. Pin site care for preventing infections associated with external bone fixators and pins. Cochrane Database Syst Rev. 2004;(1):CD004551.Google Scholar
  7. 7.
    Camilo AM, Bongiovanni JC. Evaluation of effectiveness of 10% polyvinylpyrrolidone-iodine solution against infections in wire and pin holes for Ilizarov external fixators. Sao Paulo Med J. 2005;123(2):58–61. Epub 2005 Jun 8.PubMedCrossRefGoogle Scholar
  8. 8.
    Davies R, Holt N, Nayagam S, Temple J, Santy JJ. The care of pin sites with external fixation. J Bone Joint Surg Br. 2005;87(5):716–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Van den Bossche MR, Broos PL, Rommens PM. Open fractures of the femoral shaft, treated with osteosynthesis or temporary external fixation. Injury. 1995;26(5):323–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Hutson Jr JJ, Zych GA. Infections in periarticular fractures of the lower extremity treated with tensioned wire hybrid fixators. J Orthop Trauma. 1998;12(3):214–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Nowotarski PJ, Turen CH, Brumback RJ, Scarboro JM. Conversion of external fixation to intramedullary nailing for fractures of the shaft of the femur in multiply injured patients. J Bone Joint Surg Am. 2000;82(6):781–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Parameswaran AD, Roberts CS, Seligson D, Voor M. Pin tract infection with contemporary external fixation: how much of a problem? J Orthop Trauma. 2003;17(7):503–7.PubMedCrossRefGoogle Scholar
  13. 13.
    Stavlas P, Polyzois D. Septic arthritis of the major joints of the lower limb after periarticular external fixation application: are conventional safe corridors enough to prevent it? Injury. 2005;36(2):239–47.PubMedCrossRefGoogle Scholar
  14. 14.
    Lerner A, Chezar A, Haddad M, Kaufman H, Rozen N, Stein H. Complications encountered while using thin-wire-hybrid-external fixation modular frames for fracture fixation. A retrospective clinical analysis and possible support for “Damage Control Orthopaedic Surgery”. Injury. 2005;36(5):590–8. Epub 2005 Jan 21.PubMedCrossRefGoogle Scholar
  15. 15.
    Mason WT, Khan SN, James CL, Chesser TJ, Ward AJ. Complications of temporary and definitive external fixation of pelvic ring injuries. Injury. 2005;36(5):599–604.PubMedCrossRefGoogle Scholar
  16. 16.
    Egol KA, Tejwani NC, Capla EL, Wolinsky PL, Koval KJ. Staged management of high-energy proximal tibia fractures (OTA types 41): the results of a prospective, standardized protocol. J Orthop Trauma. 2005;19(7):448–55, discussion 456.PubMedCrossRefGoogle Scholar
  17. 17.
    Bibbo C, Brueggeman J. Prevention and management of complications arising from external fixation pin sites. J Foot Ankle Surg. 2010;49:87–92.PubMedCrossRefGoogle Scholar
  18. 18.
    Egol K, Paksima N, Puopolo S, Klugmam J. Treatment of external fixation pins about the wrist: a prospective, randomized trial. J Bone Joint Surg (Am). 2006;88:349–54.CrossRefGoogle Scholar
  19. 19.
    Moroni A, Orienti L, Stea S, Visentin M. Improvement of the bone-pin interface with hydroxyapatite coating: an in vivo long-term experimental study. J Orthop Trauma. 1996;10(4):236–42.PubMedCrossRefGoogle Scholar
  20. 20.
    DeJong ES, DeBerardino TM, Brooks DE, Nelson BJ, Campbell AA, Bottoni CR, et al. Antimicrobial efficacy of external fixator pins coated with a lipid stabilized hydroxyapatite/chlorhexidine complex to prevent pin tract infection in a goat model. J Trauma. 2001;50(6):1008–14.PubMedCrossRefGoogle Scholar
  21. 21.
    Pommer A, Muhr G, David A. Hydroxyapatite-coated Schanz pins in external fixators used for distraction osteogenesis: a randomized, controlled trial. J Bone Joint Surg Am. 2002;84-A(7):1162–6.PubMedGoogle Scholar
  22. 22.
    Cimerman M, Cor A, Ceh M, Kristan A, Pizem J, Tonin M. Microstructural analysis of implant-bone interface of hydroxyapatite-coated and uncoated Schanz screws. J Mater Sci Mater Med. 2005;16(7):627–34.PubMedCrossRefGoogle Scholar
  23. 23.
    Green SA. Complications of external skeletal fixation. Springfield: Charles C. Thomas; 1981. p. 12–42.Google Scholar
  24. 24.
    Scalea TM, Boswell SA, Scott JD, Mitchell KA, Kramer ME. External fixation as a bridge to intramedullary nailing for patients with multiple injuries and with femur fractures: damage control orthopedics. AN J Trauma. 2000;48(4):613–21, discussion 621–3.CrossRefGoogle Scholar
  25. 25.
    Oh JK, Hwang JH, Sahu D, Jun SH. Complication rate and pitfalls of temporary bridging external fixator in periarticular comminuted fractures. Clin Orthop Surg. 2011;3:62–8.PubMedCrossRefGoogle Scholar
  26. 26.
    Dickson KF, Montgomery S, Field J. High energy plafond fractures treated by a spanning external fixator initially and followed by a second stage open reduction internal fixation of the articular surface – preliminary report. Injury. 2001;32 Suppl 4:SD92–8.PubMedGoogle Scholar
  27. 27.
    Sabharwal S, Kishan S, Behrens F. Principles of external fixation of the femur. Am J Orthop. 2005;34(5):218–23.PubMedGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2012

Authors and Affiliations

  1. 1.Department of Orthopaedic TraumaUniversity of Miami Leonard M Miller School of MedicineMiamiUSA

Personalised recommendations