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Articulating external fixation to overcome nerve gaps in lower extremity trauma
1Department o fOrthopaedic Surgery, Wake Forest University Baptist Medcial Center, Winston-Salem, NC 27157, USA. druch@wfubmc.edu
Journal of Orthopaedic Trauma
|April 8, 2003
Summary
Articulating external fixation aids nerve repair in lower extremity trauma. This technique allows tension-free nerve repair and gradual lengthening, improving motor and sensory function in patients.
Area of Science:
- Orthopedic Surgery
- Neurotrauma
- Limb Reconstruction
Background:
- Segmental nerve defects in lower extremity trauma often necessitate nerve grafting.
- Optimal positioning is crucial for tension-free nerve repair and successful limb salvage.
Observation:
- Four patients with lower extremity trauma and segmental nerve defects were treated with articulating external fixation.
- This device allowed for precise joint positioning to facilitate end-to-end nerve repair.
Findings:
- Following three weeks of immobilization and gradual lengthening, patients showed significant functional recovery.
- Median motor grade M4 for gastroc-soleus function and protective plantar sensation were observed at 44 months follow-up.
Implications:
- Articulating external fixation offers a safe and effective alternative to nerve grafting for specific trauma cases.
- This method facilitates primary neurorrhaphy and supports successful limb salvage in complex lower extremity injuries.