[A.L.J. external fixation. Indications and results in 59 cases]

The authors report their results in 59 cases of external fixation with A.L.J. type devices inserted from November, 1984, to November, 1988, in 57 patients (2 cases of bilateral injuries). These included 49 cases of "recent" traumatology, 4 cases of "second-hand" traumatology, and 6 orthopaedic cases (tibiotarsal arthrodesis for degenerative lesions). Among the recent traumatic injuries, 38 were fractures, most often compound fractures (stages II and III), and 11 serious soft tissue lesions, for which the external fixation was used temporarily for stabilization until the wound was healed. The older traumatological lesions were 4 infected pseudarthroses. The results based on 52 cases (6 were lost to follow-up and 1 is a peculiar case) include 45 healed injuries (ie. 86.5%) and 7 failures. The soft-tissue lesions have all healed within 2 to 4 months. Among the bony lesions, some knit primarily without an additional graft (20 of 37 cases, ie 54 percent), the others after 1, 2 or 3 grafts (10 of 37 cases, ie. 27 percent). The union also occurred without any problem for all 6 tibiotarsal arthrodeses. The 7 failures occurred in cases where no additional bone graft had been performed. The discussion evidences the advantages and drawbacks of the A.L.J.