External fixation for skeletal stabilization of severe open fractures of the hand

The successful use of external fixation to stabilize severe open fractures elsewhere in the body has led to its adaptation in the hand. It is particularly useful when extensive wounds prohibit internal fixation and when comminution and bone loss render the fracture difficult to control by other methods. External fixation permits simultaneous wound access and fracture management. It can be used alone or adjunctively with other methods of fixation such as Kirschner wires, screws, or plates for definitive fracture management. Alternatively, external fixation can be used for provisional fracture management until wound conditions permit the application of other means of osteosynthesis.