A Modified External Fixation Device for Treating Open Fractures of the Lower Extremities: Two Case Reports

Open fractures of the lower extremities are often poor candidates for early internal fixation due to severe soft tissue injury and high risk of infection. Although traditional external fixation can effectively stabilize fractures and protect soft tissues, it presents several drawbacks, including a bulky structure, poor mechanical stability, inconvenience in dressing and ambulation, and difficulty in combined application with vacuum sealing drainage (VSD). To overcome these limitations, we designed a compact, lightweight modified external fixation device. Its biomechanical stability was enhanced by increasing plate thickness and thread depth. We report two male patients, aged 44 and 56, with open tibial and femoral fractures who underwent debridement and suture followed by stabilization with this modified external fixation device. Following surgery, both patients were capable of early partial weight-bearing walks without any complications such as pin tract infections, fixation loosening, or nonunion. Radiographic follow-up demonstrated satisfactory fracture healing, with bony union achieved at 12 and 20 weeks, respectively. The device features a compact structure, facilitating combined use with VSD, and offers ease of operation and high patient comfort. This preliminary experience suggests that the modified external fixation device is a feasible option for selected open lower extremity fractures, though further validation is required.