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Spanning External Fixation for the Treatment of Open Joint Injuries in Pediatric Burn Patients

Kelly Carmichael1, Daniel Torres2, Carlos J Jimenez3

  • 1Department of Orthopaedic Surgery and Rehabilitation, University of Texas Medical Branch.

Cureus
|June 21, 2018
PubMed

Insights

Spanning external fixation (SEF) effectively treats pediatric open joint burn injuries, reducing the need for multiple skin grafts. Early SEF application promotes healing and improves outcomes for these challenging cases.

Area of Science:

  • Orthopedic Surgery
  • Pediatric Burn Care
  • Trauma Management

Background:

  • Open joint injuries in pediatric burn patients are complex and challenging to manage.
  • Traditional treatments often involve multiple interventions, including extensive skin grafting.

Observation:

  • A case series reviewed nine pediatric patients with open joint burn injuries treated with spanning external fixators (SEFs).
  • Patients presented with severe burns (average 49.4% TBSA), affecting elbows and knees, with an average age of 8.6 years.
  • SEF placement occurred an average of 7.1 weeks post-burn, following numerous prior skin grafting procedures.

Findings:

  • SEF treatment resulted in a significant reduction in subsequent skin grafting procedures (average 0.6 post-SEF vs. 3.8 pre-SEF).
  • The average duration of SEF placement was 6.4 weeks.
  • Two complications (22%) were noted, related to fixation failure.

Implications:

  • Spanning external fixation is an effective treatment for pediatric open joint burn injuries.
  • Early SEF application is recommended to facilitate soft tissue healing and minimize the number of required skin grafting procedures.
  • This approach offers a viable solution for managing these uncommon and difficult pediatric burn complications.

Keywords:
childrenexternal fixatoropen joint burnsorthopedics

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