Far-forward fracture stabilization: external fixation versus splinting

Area of Science:

• Orthopaedic Surgery
• Military Medicine
• Trauma Care

Background:

• Modern body armor improves soldier survival but increases extremity trauma.
• Forward-deployed surgeons face challenges managing severe limb injuries.

Purpose of the Study:

• To outline the principles for selecting and applying external fixation and splinting devices in combat settings.
• To emphasize the importance of these techniques for limb salvage and life preservation.

Main Methods:

• Review of current practices and considerations for battlefield orthopaedic interventions.
• Discussion of the advantages and indications for external fixation versus splinting.

Main Results:

• External fixation offers benefits including soft-tissue protection, infection reduction, hemorrhage control, pain management, and easier evacuation.
• Splinting is appropriate for specific stable fractures or those unsuitable for field external fixation; casts are contraindicated due to compartment syndrome risk.

Conclusions:

• Surgeons must tailor device selection based on tactical environment, injury severity, location, resources, and experience.
• Proficiency in both external fixation and splinting is crucial for optimal outcomes in combat casualty care.