The use of external fixators in the treatment and rehabilitation of compound limb injuries

Application of the Wagner leg lengthening apparatus, the A-O tubular system, and the Avmedica-Shiba external fixator in the treatment of severe compound limb fractures is reported. The application of the fixation frame at the time of patient arrival, together with aggressive surgical debridement of lacerated tissues and early skin grafting, followed five days later by patient and joint mobilization, has significantly improved the results of treatment. The time of hospitalization was shortened, and the complication rate was low with no deep infection, in the face of a nonunion rate of 10%. In the lower limb, with the appearance of callus formation the transfixing pins were removed, and cast brace immobilization substituted. In the upper limb, external fixation was continued until complete bony healing was achieved.