External fixation in treatment of false joints and bone losses using vascularized grafts

Different kind of external fixator osteosynthesis in the treatment of pseudoarthroses and bone defects with vascularized bone grafts are presented. Construction features of different external fixators are discussed based on clinical material of 48 patients, who have had different vascularized bone graft surgery. For tibia treatment mainly external plate ixator "Zespol" was used. Its advantages such as simplicity of construction, small size and weight and easy application are presented. The possibility of joining the external plates allowes using this method in the treatment of bone defects of arbitrary length. Some restrictions of this method are also pointed out. Fixators of larger size were used for treatment of femoral pseudoarthroses and bone defects. Emphasis was put on advantages and disadvantages of multiplane static fixators and unilateral fixators. The importance of weight bearing and dynamization for bone healing process were discussed. It seems that external fixator whose construction allows to adjust the dynamization level at various stages of the healing process is the best method of treatment of complications of bone union.