The unilateral external fixator (Monofixator) in acute fracture treatment: experience in 50 fractures

From 1988 to 1992, 50 fractures with associated soft tissue lesions were treated with an unilateral fixator (Monofixator). The location of the fracture was the tibia in 39 cases, the pelvis in 5 cases, the femur in 4 cases, the ankle and the humerus in one patient respectively. Twenty-two tibial fractures (56%) were open. Unproblematic healing with the monofixator was achieved in 71.8% of tibial fractures after a mean healing time of 18.2 weeks. Axial dynamic compression was performed in 18 tibial fractures. Planned reosteosynthesis was performed in 7 tibial fractures (18%). After secondary internal osteosynthesis, no late problems were seen. Complications with the monofixator in acute tibial fracture treatment consisted of refracture in 3 patients, pin track infection in 2 patients and hypertrophic pseudarthrosis in one patient. The monofixator provides a safe and stable fixation in tibial fractures with important associated soft tissue damage. In haemodynamically unstable patients with severe associated lesions, pelvic ring and femoral fractures can be reduced and stabilized satisfactorily with a monofixator, mostly until better condition permits definitive osteosynthesis.