[Change in treatment procedure after primary external fixator osteosynthesis in polytrauma patients]

In polytrauma patients stabilisation of fractures is of minor importance compared with life-saving surgical interventions concerning the body cavities. Because of persisting instability especially of long bones with disadvantageous effects on the state of shock and the respiratory system (fat embolism, ARDS) early stabilisation of fractures should be achieved. In our experience the majority of cases allows external fixation of long bone fractures simultaneously with or following the life-saving operations. Postoperative positioning and nursing as well as additional diagnostic procedures are considerably facilitated. An early change of the stabilisation method should be performed as soon as possible if tolerated by the general and soft tissue conditions. Follow-up of 54 patients with 76 fractures stabilised primarily by external fixator demonstrates our experiences with planning and realisation of the change of stabilisation method. The functional and radiological results after an average of 28 months are pointed out.