The Application Of Hybrid External Fixation In The Treatment Of Complex Extremity Fracture

Objective: To research the clinical effect of treating complex extremity fracture by hybrid external fixation .Methods: 37 cases complex extremity fracture were treated surgically by hybrid external fixation from Jun 2004 to Dec 2006 including 27 male and 10 female. The age of the subjects were 12～55 years (average age: 39.3). Pre-operative diagnosis: 22 cases fresh fractures including 2 cases humerus comminuted fracture, 8 cases radial comminuted fracture (6 cases distal radial comminuted fracture and 2 cases simple fracture), 3 cases femoral comminuted fracture (1 cases open fracture and 2 cases condylus comminuted fracture), 8 cases tibia comminuted fracture (6 cases tibial plateau fracture, 2 cases distal comminuted fracture and 5 cases with compartment syndrome), 1 cases pelvic comminuted fracture. 7 cases nonunion including 1 case distal humerus nonunion, 4 cases tibia nonunion, 1 case distal tibia nonunion, 1 cases Monteggia fracture. 8 cases nonunion due to infection including 7 cases tibia and 1 cases subtrochanteric fracture. All of the cases were treated surgically by hybrid external fixator made by Beijing External Fixation Institute. 9 cases of the fresh fracture were operated reduced and fixed closely by needly. 11 cases received autogenous bone or artificial bone transplantation. All the simple nonunion cases received autogenous bone or artificial bone transplantation. All the cases with compartment syndrome were opened to reduce tension and given secondary suture or dermatoplasty. None of the above got infectious. Intensive case was given to the pin point. All the patients were encouraged to do functional excise. X-ray were taken immediately and 1st, 2nd, 3rd, 6th, 9th,12th,15th,18th month after operation respectively. The amount of excise were increased according to the growth of osteotylus. If it reached the clinical union standard, the external fixation could be dismantled. Result:All the 37 cases were followed up for 3 to 20 months (average 12 months). The union time for fresh fracture was 3 to 6 months. The union time for simple nonunion was 6 to 16 months. The union time for infectious fracture was 7 to 12 months. 2 cases showed evident pin hole infection, which reached union by pulling out the pin and changing dressings regionally. 2 cases showed obvious limitation of flexion, which were distal femoral comminuted fracture cases. Conclusions with the advantages like minor trauma, reliable fixation, high cure rate and lower complication treating complex extremity fracture by hybrid external fixator showed considerable clinical effect.