External skeletal fixation using methylmethacrylate. Current technique, clinical results, and indications.

External skeletal fixation using self-curing acrylic resin was applied by inserting A-O cortical screws into the diaphyseal region and A-O cancellous screws into the epiphyseal and/or metaphyseal regions. The position of the screws was designed to secure three-dimensional fixation. Points of insertion are selected that avoid infected bone, open wounds, thick muscles, and skin that is relatively mobile during joint motion. After reduction the acrylic resin rather than conventional metal linking devices is used for fixation of the screws. Once the fixation is completed, it is adjustable and so rigid that exercises for joint function are possible. The apparatus is light in weight and sufficiently compact to fit under clothing. In the 204 patients treated by this method, open tibial fractures occurred in 123; nonunion or delayed union in 28; metaphyseal and epiphyseal fractures in 30; femoral fractures in ten children; and miscellaneous fractures and other conditions in 13. Nearly all of the operations were successful. Three patients had refractures after removal of the fixation device.