The role of external fixator in damage control orthopedics for the patients with polyfractures

Abstract

Objective To evaluate the role of external fixation in the early damage control of serious polyfractures.Methods From January 2006 to June 2010,42 cases of serious polyfractures were treated with external fixators in our department.They were 29 males and 13 females,with a mean age of 39.2 years (from 21 to 62 years).Among them,28 cases were complicated with injury to other organs and 31 cases with hemorrhagic or traumatic shock.Their average injury severity score(ISS) was 34 points.Active anti-shock interventions combined with external fixation were applied in the emergency phase.Then the patients were transferred to ICU for further resuscitation.Definitive treatments were based on the general conditions of specific patients.Results Two patients died,one due to hemorrhagic shock and the other brain trauma.The mortality rate was 4.8％.Acute respiratory distress syndrome occurred in one case,pulmonary embolism in one case and lower extremity deep infection in 2 cases.Altogether 36 patients obtained an average follow-up of 16 months (from 8 to 36 months).Follow-ups revealed fractures healing in all cases after a mean time of 22 weeks.Conclusion In the early damage control of severe polyfractures,external fixators play a very important role in effectively reducing the mortality rate and facilitating further treatment,because they are simple and non-invasive. Key words: Multiple trauma;  Fracture;  External fixators