Management of severe open fracture of lower limbs with external fixation

• Main Author: Mohd Yusof, Nazri
• Format: Proceeding Paper
• Language: English; English; English
• Published: 2023
• Subjects: RD701 Orthopedics
• Online Access: http://irep.iium.edu.my/107952/1/Management%20of%20severe%20open%20fracture%20of%20lower%20limbs.pdf; http://irep.iium.edu.my/107952/2/Scientific%20Program%20-%2020231102.pdf; http://irep.iium.edu.my/107952/13/world%20medical%20reports.jpeg; http://irep.iium.edu.my/107952/

The aim of open fracture management is to save life, prevent infection and promote fracture healing. This is done through resuscitation, emergency debridement, temporary stabilization with an external fixator, early soft tissue coverage and end with bone reconstruction. The spanning external fixation is done out of the zone of injury in a safe manner. Early wound closure should be done within a week with conversion of internal fixation. The risk of infection increases if the conversion to internal fixation is done after 2 weeks unless the pin site does not go through the plan of internal fixation. Bone reconstruction is done after the wound is covered by distraction osteogenesis or bone graft. Sometimes, when complex plastic surgery is not possible, bone and soft tissue procedures can be done together with distraction osteogenesis as a salvage procedure. Bone and soft tissue defects can also be treated with a vascularised fibular osteocutaneous flap. A circular external fixator fixed with tension wire is suitable for severe intra-articular open fracture or fracture that extends to the diaphyseal region. The circular fixators also allow the fixation across the joint that protects the articular fragment and at the same time allows joint movement.