[External fixation--rare indications, combination of internal and external osteosynthesis technics, secondary...

The rare application of external stabilisation requires special knowledge of its indications and surgical assembly, which are closely linked to usually serious bone and soft-tissue damage, topographical prerequisites and biomechanical requirements. This paper differentiates the indications for external osteosynthesis of the femur, immobilisation using external fixation to bridge a joint, unstable fractures of the pelvic girdle, osteosynthesis and application of the fixateur externe in the region of the knee, hip and hand joints, as well as the foot. Combinations of internal and external osteosynthesis techniques in the femur and tibia are presented and discussed. Criteria are discussed for changing from primary external to final internal osteosynthesis, as well as osteotaxis indicated solely by the soft tissue or in plastic surgery.