External fixation in war trauma management of the extremities--experience from the war in Croatia

During 18 months, the authors treated 109 wounded patients whose complicated gunshot fractures were externally fixated. The total of 116 external fixators were applied. Besides bone fractures, blood vessels, nerve, and soft-tissue injuries required additional reconstructive procedures. The most frequent complications were infection of the tissue surrounding pins (35.34%), osteomalacia around the pins (18.10%) and osteomyelitis (7.70%). In 25 patients (21.55%) the external fixation was removed after the treatment of fractures. In eight wounded patients (6.89%) surgery had to be repeated to correct the inadequate position of bone fragments.