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Article
External fixation in the Treatment of Intertrochentric Fractures in Elderly Patients
عملية التثبيت الخارجي في علاج كسر بين المدورين الفخذي عند المرضى المسنين

Author: Firas Mohammed Abdul Ghani
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2014 Volume: 11 Issue: 2 Pages: 365-372
Publisher: Babylon University جامعة بابل

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Abstract

Objective: To evaluate the results of external fixation for intertrochentric hip fractures in elderly patients with high anesthetic risk.Patients and methods: Prospective study conducted at Department of Orthopedic surgery in Al-Kadhemia Teaching Hospital from January 2007 to October 2013 to evaluate 31 patients, with intertrochentric fracture and high risk for anesthesia, 19 females and 12 males, age between (47 – 90) years. All fractures were stabilized with external fixator under spinal, epidural, general and even local anesthesia.Results: The average time of operation was 35 minutes (25-50), no one needs blood transfusion.No mortality in immediate post operative period .but three died after 10 days of operation because of co morbid disease. Bony union is obtained in the rest of patients, in 16 weeks, most patients had excellent and good results according to judget functional score, Pin tract infection and Deep vein thrombosis is the commonest complication.The use of external fixator was associated with significant less blood loss, shorter operative time, reduction in post operative pain, shorter hospitalization.Conclusion: External fixation in elderly patients with high anesthesia risk is fast, minimally invasive procedure in the treatment of intertrochentric fracture, resulting in fewer pre and post operative complication.

يعتبر كسر بين المدورين الفخذي من الكسور الشائعة بين كبار السن.ونضرا للإمراض المرافقة والمزمنة عند المريض التي تجعل تخدير المريض خطرا وصعبا ,قمنا باستعمال طريقة التثبيت الخارجي في تثبيت الكسر باستعمال جهاز الاشعه وبطريقه مغلقه.أجرينا العملية على واحد وثلاثون من المرضى كبار السن في ردهة الكسور في مستشفى ألكاظميه التعليمي المصابين بكسر بين المدورين والمصابين بإمراض مزمنة وتحتم استخدام طريقه علاج سريعة وأمينهأثبتت المتابعة لمده ستة أشهر إن 100% من الكسور قد التأمت في الوقت المحدد وان التقييم الو ضيفي للنتائج كان كالآتي:ممتازة 21%,جيده 43%,مقبوله29%,ضعيفة 7%إن تثبيت الكسر بين المدورين بالتثبيت الخارجي هي عمليه بسيطة ومعتمده لتثبيت هذا النوع من الكسور خصوصا للمرضى كبار السن والمصابين بإمراض أخرى ويمكن اعتبارها بديلا جيدا للتثبيت الداخلي.


Article
Assessment of Postoperative Nurses' Practices Concerning Care of Fracture Treated by External Fixation
تقييم ممارسات الممرضين مابعد الجراحة بخصوص العناية بالكسر المعالج بواسطة التثبيت الخارجي

Authors: Narmeen B. Tawfiq --- Thani A.Radhi
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2016 Volume: 6 Issue: 1 Pages: 24-32
Publisher: University of Kufa جامعة الكوفة

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Abstract

Objectives: to assess nurses' practice level toward care of fracture treated with external.Methodology: A descriptive study was carried out at orthopedic wards in Al-Zhrawi Surgical Hospital -Missan Governorate. The study started from November 11th, 2014 to June15th, 2015. A non-probability sample of (50) orthopaedic nurses (male & female) who were working in orthopedic wards. The data were collected through the use of questionnaire, which consists of three parts, part(1)Demographic data form that consists of (8) items, part(2) concerning nurses' practices level toward patient treated with external fixation consist from (25)items, part(3) consist from(9) items concerning with external fixation device care. Checklist was used to collect data for orthopedic nurses. The validity of the checklist was determined through presenting it to (15) specialist expert and its reliability were determined through a pilot study which was carried out through the period from (22Jan-to 10th Feb, 2015). Descriptive statistical analysis procedures inferential analysis procedures were used for the data analysis.Results: Discussions of the study result indicated that the majority of items had low M.S (less than1.66)Conclusion: From the results it conclude that the orthopedic nurses have inadequate or deficit in some aspects related to postoperative care for patient undergoing external fixation surgery in orthopedic wards.Recommendations: The researcher recommend a special training sessions should be designated and presented to all orthopedic nurses that include specific training programs about nurses' intervention concerning care of fracture treated with external fixation. Authorizing and distributing a manual handbook or pamphlet to all nurses who work in orthopedic wards including nursing interventions in postoperative.

الهدف: تهدف الدراسة لتقييم مستوى ممارسات الممرضين تجاه العناية بالكسر المعالج بالتثبيت الخارجي.المنهجية: دراسة وصفية اجريت في ردهات جراحة العظام في مستشفى الزهراوي الجراحي- محافظة ميسان للمدة من 11 تشرين الثاني 2014 ولغاية 15 حزيران 2015.اختيرت عينة غرضية "غير احتمالية" مكونة من (50) ممرضا وممرضة من العاملين في ردهات الكسور. جمعت البيانات من خلال استبانة مصممة ومكونة من ثلاثة اجزاء, الجزء الاول شمل الخصائص الشخصية للمرضين ويحتوي على(8) فقرات, والجزء الثاني تخص ممارسات الممرضين تجاه المرضى الذين يجرى لهم جراحة التثبيت الخارجي مكونة من (25) فقرةو الجزء الثالث يتكون من (9) فقرات تختص بممارسات الممرضين بخصوص العناية بجهاز التثبيت الخارجي.جمعت البيانات بطريقة الرصد للمرضين العاملين في ردهات الكسور. حددت مصداقية استمارة الاستبانة من خلال عرضها على (15) خبير من ذوي الاختصاص وحدد ثباتها من خلال اجراء الدراسة المصغرة للمدة من 22كانون الثاني 2014 ولغاية 10 شباط 2015. تم وصف تحليل البيانات باستعمال اساليب الاحصاء الوصفيو الاحصاء الاستنتاجي.النتائج: بينت النتائج ان غالبية فقرات الدراسة قد اظهرت ضعفا في التداخلات التمريضية بعد اجراء جراحة التثبيت الخارجي.الاستنتاج: نستنتج ان هناك نقصا وقلة في ممارسات الممرضين العاملين في ردهات الكسوربعد اجراء جراحة التثبيت الخارجي .التوصيات: يوصي الباحث بضرورة اعداد برامج خاصة لتدريب الملاكات التمريضية العاملة في وحدات الكسور تجاة العناية بالكسر المعالج بالتثبيت الخارجي. تصميم كتيب او كراسحول كيفية تقديم العناية التمريضية للمرضى بعد اجراء جراحة التثبيت الخارجي .


Article
External Fixation with Supplementary Intramedullary Kirschner Wires in the Treatment of Unstable Distal Radial Fractures
علاج كسر اسفل عظم الكعبره (غير المستقر) باستخدام جهاز التثبيت الخارجي المدعم بالكي واير

Author: Mohammed Jafer Jawad Al-Musawi محمد جعفر جواد الموسوي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2013 Volume: 26 Issue: 1 Pages: 85-92
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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AbstractBackground: External fixation is a popular method to reduce osseous deformity of the distal radius, but cannot assure maintenance of the reduction. Supplementing external fixation with intramedullary Kirschner wires can improve retention of fracture reduction during healing, resulting in better functional results.Objectives: To determine radiographic and functional outcomes in unstable distal radius fracture treated by close reduction and external fixation, with supplementary intramedullary Kirschner wires.Patients & methods: 26 distal radius fractures were treated with external fixation supplemented with intramedullary wires. The fractures were evaluated via good-quality posteroanterior and lateral radiographs. The radial height, radial inclination and volar tilting were measured on initial (preoperative) and immediate postoperative radiographs and on others taken immediately after the removal of external fixation. Overall results were based on objective radiographic and functional data as well as on subjective assessments with demerit-point scoring. Results: In our study ,we found that there is a great relationship between radiological restoration of the length of distal radius and functional outcome ,using the Dermerit point-rating system ,we found that 23 patients (89% ) had excellent or good result ,2 patients (8%) were classified as fair ,and 1 patients (3%) had poor results. Radial height, volar tilt of distal radius deformity and radial inclination improved significantly immediately after surgery, when external fixation was supplemented with intramedullary Kirschner wires. Clinical examination likewise found significantly better functional results regarding range of motions & grips strength.Conclusion: External fixation is a popular method to reduce osseous deformity of the distal radius, but cannot assure maintenance of the reduction. Supplementing external fixation with intramedullary Kirschner wires can improve retention of fracture reduction during healing, resulting in better functional results.Keywords: Unstable distal radius, external fixation, K-wires

الملخصالخلفيه البحثيه: استخدام جهاز التثبيت الخارجي المدعم بالكي واير لعلاج كسر عظم اسفل الكعبره (غير المستقر) والذي فيه تفت ظهري او زيحان كبير او امتداده لمفصل الرسغ من اجل الحصول على نتائج شعاعيه وسريريه جيده لايمكن الحصول عليها باستخدام طرق علاجيه اخرى الهدف: تقييم دور جهاز التثبيت الخارجي المدعم بالكي واير في علاج كسر اسفل عظم الكعبره (غير المستقر).طريقه العمل: استخدمت في هذه الدراسه 26 مريض في مستشفى اليرموك للفتره من كانون الاول 2009 لغايه اب 2011 وقد تراوحت اعمار المرضى مابين 52 للاناث و31 سنه للذكور وبمعدل 46 سنه وكان عدد مرضى الذكور 11 والاناث 15 وقد اجريت الفحوصات الشعاعيه لهم قبل العمليه وبعد العمليه مباشره وبعد رفع جهاز التثبيت الخارجي والداخلي وقد اعتمدت نتائج الدراسه على (حرزدرمت) لغرض معرفه النتائج النهائيه للمرضى النتائج: أظهرت الدراسة أن هناك علاقة كبيرة بين نتائج الفحوصات الشعاعية لأسترجاع الشكل الطبيعي لنهاية عظم الكعبرة والوظيفة الطبيعية له فيما يخص استرجاع حركة مفصل الرسخ وانقباض اليد, وبأستخدام حرز درمت أظهرت النتائج النهائية لـ (25) من المرضى المصابين بكسور غير مستقرة في أسفل عظم الكعبرة حيث كانت النتائج مرضية (جيد او ممتاز في 23 مريض) (89ٍ%) وكانت (مناسبه في 2مريض) (8%) وكانت (غير مناسبه في 1مريض) (3%) حيث تم استخدام جهاز التثبيت الخارجي المدعم بالكي واير لغرض التثبيت.الاستنتاج: استخدام جهاز التثبيت الخارجي المدعم بالكي واير يعطي نتائج جيده شعاعيا وسريرا وهي طريقه مناسبه للتقليل من التشوهات والاختلاطات التي تحدث لكسر اسفل عظم الكعبره (غير المستقر) نتيجه استخدام طرق علاجيه اخرى حيث ان دعم جهاز التثبيت الخارجي يساعد في تحسين وارجاع الكسر من غير مستقر الى مستقر والحفاظ عليه خلال فتره بناء الكسر وبالتالي يعطينا نتائج سريريه جيده


Article
Open Reduction and Internal Fixation Compared to Closed Reduction and External Fixation in Distal Radial Fractures Arandomized Study of 40 Patients

Authors: Diaa Gafar Sadik ضياء جعفر سادق --- Zaid Abdali زيد عبد علي
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 1 Pages: 1842-1849
Publisher: Kerbala University جامعة كربلاء

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Objective: to investigate if open reduction and internal fixation would produce better outcome than external fixation of distal radial fractures.Patients and Methods: 40 patients with unstable or comminuted distal radial fracture where divided randomly into two groups using 2 methods of treatment, in group one closed reduction &bridging external fixation was used ,in group tow open reduction &internal fixation was used. The primary outcome parameter was grip strength, but the patients were followed for 1 year with objective clinical assessment, subjective outcome and radiographic examination.Results & Discussion: At one year postoperatively , grip strength was 89%(standard deviation 15) of the injured side in the internal fixation group and 75%(15) in the external fixation group. Pronation /supnation was 150 (15)in the internal fixation group &136 in(20) in the external fixation group at 1year.4 patients in the external fixation group where reoperated due to malunion as compared to 2 in internal fixation group.6 others are classified as radiographic malunion, 5 in the external fixation ,1 in the internal fixation group.Conclusion: internal fixation gave better grip strength &and better range of motion at one year, and less malunion than external fixation. No difference could be found regarding subjective outcome.


Article
Management Of Tibial Pilon Fractures With Spanning External Fixator Supported By K-Wires Fixation

Author: Zaid W. Al-Shahwanii زيد الشهواني
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2017 Volume: 16 Issue: 1 Pages: 63-73
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: Pilon fractures of distal tibia result from axial load with high energy force That produce a spectrum of articular and metaphseal fractuers which are difficult to manage , especially when associated with soft tissue injuries with a high rate of complications when treated with primary open reduction & internal fixation, this drive the surgeon’s to use spanning external fixator & limited internal fixation like k-wirs as an alternative techique for definitive management.Patients & Method:Twenty cases of fractures of tibial pilon were collected; studied & treated in Al-Yarmook teaching hospital and Red Crescent surgical hospital during the period from October 2013 - october 2015..The average age of the patients were thirty five years (range from twenty tofifty years),16 cases were male, 4 cases were female.. 14 cases of them had associated fibular fracture . all are managed by Spanning External fixation with k-wires supplment as an internal fixation to hold the scattered pieces of articular surface .. Results: among those 20 cases there are 8 cases had a good results regarding ankle movement a good union with preservation of ankle mortise .While 9 cases had fair results due to either mal-union or limitation of ankle movements and only 3 casesended with poor results. There were only two cases complicated with infection (tibial osteomyelitis) (caseNo. 10 & No. 13) & were treated by proper antibiotics according to culture & sensitivity, also we had nine patients complain from pin tract infection which were treated by antibiotics and daily dressing.Discussion: The use of external fixation supported by k-wires to treat the metaphyseal portion of pilon (tibial plafond ) fractures with articular surface involvement has been reported to be associated with a lower rate of wound complications than open reduction & internal fixation.. and a good result of union .


Article
Management of Compound Comminuted Fractures in and Around Elbow Joint Using Across Elbow External Fixation Followed By Eearly Active Movement

Author: Ali Bakir Al-Hilli
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2008 Volume: 7 Issue: 3 Pages: 201-208
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACK GROUND:Compound comminuted fractures around elbow are one of the most common injuries in our country today due to high velocity missile injuries they present a great challenge to the orthopaedic surgeon and severe suffering to the patients as comminution makes anatomical reduction impossible and stiffness is a well known associate .This study was designed to evaluate the functional outcome for such injuries.OBJECTIVE:To evaluate the functional results of management of compound fractures in and around elbow joint using across elbow external fixation and early physiotherapy.METHODS:A case series study was designed, a (20) patients presented to the orthopaedic and trauma department in the Medical City / Surgical Specialties teaching Hospital / Baghdad/ during the last two years 2006-2007 , with history of high velocity missile injury to their elbow or around it, all of them treated by early wound excision and application of across elbow external fixation followed up for 6 weeks till healing of their wounds then the external fixation was removed and active assisted movement were started, patients followed up for 6 months and assessed both clinically and radiographically.RESULTS:Good range of elbow movement and return to the original work of the patients were noted in 100% of the patients, and follow up for the first 6 weeks after removal of the external fixation shows that most of the patients (15) got functional range of elbow movement, According to Mayo elbow performance score nine patient got 95 points and eleven got 85 points.CONCLUSION:Functional range of elbow movement can be achieved in compound comminuted fractures in and around elbow by using external fixation across the joint then physiotherapy.


Article
THE TREATMENT OF OPEN & CLOSED TIBIAL ‎FRACTURES BY PRIMARY EXTERNAL FIXATION & ‎BONE GRAFT

Authors: Mohammad S Al-Edany --- Thamer A Hamdan
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2005 Volume: 11 Issue: 2 Pages: 38-44
Publisher: Basrah University جامعة البصرة

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‎ We prospectively studied 64 patients with fracture shaft tibia, 23 patients with closed tibial fracture and ‎‎41 patients with open type. All fractures were stabilized by external fixation device AO/ASIF type after ‎failed manipulation under anesthesia (MUA) to restore the osseous alignment. In 28 patients cancellous ‎bone graft were used after the upper part of the tibia to enhance healing process, all these patients were ‎followed for an average of 8-12 months.‎‎ Our findings showed that stabilization of the fracture shaft tibia by external fixation with cancellous bone ‎graft had significantly better results, than external fixation alone.‎‎ The use of external fixation device with bone graft, is safe, effective, cheap and available in almost all ‎orthopaedic units n Iraq. ‎


Article
Assessment & Evaluation Of The Outcome For Closed And Open Method In The Treatment Of Closed Segmental Tibial Fracture By External Fixation
تقييم معالجة الكسور المتعددة المستويات لعظم القصبة للساق باستخدام الأسلوب الجــراحي المغلق والمفتــوح بواسطة التثبيت الخارجي

Author: Jamal Kadhim Shwayel AL-Saeedi جمال كاظم شويل السعيدي
Journal: JOURNAL OF THI-QAR SCIENCE مجلة علوم ذي قار ISSN: 19918690 Year: 2014 Volume: 5 Issue: 1 Pages: 22-31
Publisher: Thi-Qar University جامعة ذي قار

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Segmental tibial fractures are considered to be a special type of injury associated with high complication rates. The aim of our study was to evaluate and assess the outcome of our policy on dealing with closed segmental fracture of the tibia treated by (closed or open) application of external tubular device fixator (AO group of ASIF) .Within the period between October 1, 1998 and September 30, 2010 we collect 38 patients. The minimally or undisplaced fractures were treated by closed method, while those with significantly displaced fractures, firstly managed by calcaneal traction for a few days, some of them were reduced and also treated closed, and some are remain significantly displaced, treated by open reposition and external fixation with the help of X-ray control for all cases. A range of motion exercise of ankle and knee joints post operatively were encouraged.The mean age was 38.81 years. We collect and study 38 closed segmental tibial fractures i.e. (two fractures focuses for one bone), so we are dealing with 76 fractures in 38 patients. All the patients were treated by AO unilateral external fixator arranged in multiplanar technique for more rigid fixation and regarded as a definitive procedure for holding the fractures until clinical& radiological union. Then the external fixation was removed and a partial weight bearing was continued with the help of the crutches until consolidation.Healing of the bone occurred in 52 fracture focuses (68.42%) patients, and 24 fractures (31.57%) patients reported significant complications in the course of treatment that required further surgical management, 18 of them delayed union (23.68%) patients and 6 of the fracture focuses(7.89)patients go to nonunion. The delayed union treated simply by dianamyzation with chips bone graft and sometimes rearrangement of the external fixator particularly the loose pines, all of them healed completely, while the nonunited were treated by (Revision procedure):- (revision of the external fixator with wider pins and extensive refreshment of the fracture ends and added a considerable amount of bone graft), so all of them were united successfully.We conclude that the external fixation is a suitable method for the treatment of segmental tibial fractures with an acceptable rate of complications.

تعتبر الكسور المتعددة المستويات من المعضلات المهمة في جراحة العظام وخاصة لعظمة القصبة للساق حيث عادة يكون مصحوب بأضرار واصابات للأنسجة المحيطة للعظم وخاصة سمحاق العظم مما يؤثر سلبا على عملية التئام الكسور وابطاء في عملية الالتحام والاندماج العظمي. انها دراسة استرجاعية اجريت على 38 حالة مرضية للفترة من شهر اكتوبر عام 1998 الى شهر سبتمبر 2010. تم التعامل معها معالجتها من قبلي في مستشفى الناصرية العسكري ومستشفى العمارة العسكري ومستشفى الحسين التعليمي في الناصرية وذلك باستخدام جهاز التثبيت الخارجي ( النوع السويسري) لمجموعة (A.O - ASIF) حيث يتم تثبيت العظم المكسور الغير متباعد مباشرة دون فتح داخلي، اما الكسور المتباعدة فيتم تمهيديا اجراء عملية سحب عظمي مستمر من خلال عظمة الكعب لحين حصول حالة تعديل الكسر المتباعد ثم يتم بعد ذلك تثبيت الكسر دون فتح على العظم، اما الكسور التي تبقى متباعدة فيتم تعديلها داخليا وذلك بإجراء عملية فتح جراحي على موضع الكسر وتعديله ثم يتم تثبيت الجهاز الخارجي، ان هذه العمليات كلها اجريت بمساعدة بمساعدة الاشعة السينية. يتم مراقبة المريض في المستشفى بعد العملية لمدة 3 ايام حيث يتم اعطاءه المضادات الحيوية المناسبة ورفع الساق للأعلى لمنع حدوث الوذمة ثم بعد ذلك يتم اخراجه من المستشفى و المشي بمساعدة العكازات دون الضغط او المشي على الساق المكسورة (مجرد ملامسة الارض) لحين ظهور بوادر سريرية وشعاعية جيدة لالتئام العظم حيث يتم في حينها بدء الضغط الخفيف على العظم المكسور بعد اجراء ترخية وشد بسيطة للجهاز حيث تستمر عملية الضغط التدريجي على العظم لحين اكتمال الالتئام العظمي ثم بعد ذلك يتم رفع الجهاز تماما والى جانب ذلك يستمر المشي والضغط التدريجي على العظم المكسور لحين اكتمال الاندماج التام.النتائج التي تم الحصول عليها جيدة حيث تم التئام واندماج طبيعي للكسور بدون مضاعفات لحوالي 68.42% من الحالات، في حين حدث تأخير في الالتئام لحوالي 23.68% من الحالات وتم معالجتهم بنجاح بواسطة تطعيم عضمي بسيط مع ترتيب بسيط للجهاز او تغيير في بعض المسامير. في حين تم تسجيل 7.89% من الحالات لعدم الالتئام والذي هو الاخر تم معالجته بنجاح وذلك بإعادة تثبيت جهاز جديد بمسامير اوسع مع اضافة كمية كبيرة من تطعيم عظمي وتنظيف واسع لنهايات الكسر الغير ملتئم حيث تم بعدها الشفاء التام . نستخلص من دراستنا هذه ان استخدام جهاز التثبيت الخارجي لحالات الكسور المتعددة المستويات لعظم قصبة الساق تعتبر طريقة جيدة ومعتبرة وبمضاعفات مقبولة ومن الممكن السيطرة عليها.


Article
External fixation of compound femoral shaft fractures in knee flexion position

Authors: Mohamed Jaffer Jawad --- Raed A. Saadoon
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2015 Volume: 14 Issue: 1 Pages: 35-39
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Compound femoral shaft fracture (open fracture) are unsuitable to be treated by internal fixation primarily, in these situation external fixation is the treatment of choice.Aim of the study: The aim of this method (fixation of compound femoral shaft fractures using external fixators in knee flexion position) is to have a good range of knee movements immediately, post operation and later on, in comparism to classical method (external fixation in knee extension). Methods: The role of external fixation in the management of compound femoral shaft fractures is reviewed based on a study of 40 patients with compound femoral shaft fractures managed by an A O external fixator in extended knee position ( 20 patients during the period from 2003 – 2005 ) and knee flexion position ( 20 patients during the period from 2006 – 2009 ).Results: Results showed that those patients with fixation in knee flexion position have much better range of knee joint movements compared with those with knee extension position at time of fixation , without any significant differences in the of fracture healing between the 2 groups.Conclusion: External fixation of femoral fractures in knee flexion position give good range of knee motion in early and late follow up over fixation in knee extension.


Article
Immobilization of open tibial diaphyseal fracture by POP splint and external fixation device
تجميد كسر الحاجز الظنبوبي المفتوح بواسطة جبيرة POP وجهاز التثبيت الخارجي

Authors: Salahaddin H. Abdulqadir --- Omar Ameen Saeed
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2014 Volume: 18 Issue: 1 Pages: 667-673
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Tibial diaphyseal fracture is of two types, closed fracture, in which the skin is intact and open fracture in which the skin is injured. An open fracture is a type of fracture in which a break in the skin and underlying soft tissues communicates with the fracture and its haematoma .i.e. the fracture and its haematoma communicates with external environment. Our aim is to evaluate the treatment outcome of this structured protocol in terms of soft tissue injury healing and effective fracture stabilization by POP and external fixation, and to detect if there is any difference in time needed for union in both methods.Methods: This is a comparative study done in Emergency hospital in Erbil – Kurdistan region, for management of open tibial diaphyseal fractures caused by gunshot injuries. The study included 50 patients of 18 to 65 years old. Patients were divided into two groups after debridment according to methods of treatment; group 1 was managed by POP, group 2 was managed by external fixation. The patients recruited and treated over 11 month period (August 2007 to June 2008).Results: The study included 50 patients; 44 males (88%) and six females (12%). Their ages ranged between 18 years and 65 years with the mean age of 27.46 years. Patients divided into three groups according to Gustilo classification: GI included 8 patients (16%), GII included 34 patients (68%) and GIII included 8 patients (2A, 6B) (16%). There was significant difference between immobilization of open tibial diaphyseal fractures by pop and external fixation (P=0.001).Conclusion: There will be delay union of the fractures when immobilized by external fixation. It is better to remove external fixature after 6 weeks and replace it by another method of immobilization of the fracture. Treatment of type III fracture is very difficult and needs long time, usually more than one year.

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