Eichinger Josef K, McKenzie Colin S, Devine John G
Womack Army Medical Center, Fort Bragg, North Carolina, USA.
Am J Orthop (Belle Mead NJ). 2012 Jan;41(1):15-9.
External fixation of pediatric lower extremity fractures is usually reserved for severe, open fractures in polytraumatized patients, but it is often the only available treatment option for deployed military surgeons. We analyzed the outcomes and complications of 17 consecutive pediatric long bone fractures treated with external fixation at a Forward Surgical Team facility in an austere environment during Operation Enduring Freedom in Afghanistan during a 12-month period. Treatment consisted of uniplanar external fixation for 12 femoral shaft fractures (11 closed), 4 tibial shaft fractures (all open), and 1 subtrochanteric fracture (closed) in 14 males and 3 females with an average age of 7.4 years. All 17 fractures went on to union with no incidences of refracture. Complications included 1 broken pin and 3 pin site infections treated with wound care and oral antibiotics. In a deployed environment, external fixation is the treatment method of choice for lower extremity fractures by virtue of patient, environment, equipment, and mission factors. This case series validates the usage of a simple, uniplanar external fixator for a variety of open and closed pediatric long bone fractures as evidenced by the successful union rate and low number of complications.
小儿下肢骨折的外固定通常用于多发伤患者的严重开放性骨折，但对于执行任务的军队外科医生来说，它往往是唯一可行的治疗选择。我们分析了在阿富汗“持久自由行动”期间，一个前方外科团队在艰苦环境下对17例连续小儿长骨骨折进行外固定治疗的结果和并发症。治疗包括对12例股骨干骨折（11例闭合性）、4例胫骨干骨折（均为开放性）和1例转子下骨折（闭合性）采用单平面外固定，患者共14名男性和3名女性，平均年龄7.4岁。所有17例骨折均愈合，无再骨折发生。并发症包括1根固定针折断和3例针道感染，经伤口护理和口服抗生素治疗。在执行任务的环境中，鉴于患者、环境、设备和任务因素，外固定是下肢骨折的首选治疗方法。这个病例系列证实了使用简单的单平面外固定器治疗各种开放性和闭合性小儿长骨骨折的有效性，其成功愈合率和低并发症发生率就是证明。
