Introduction
Materials and Methods
To determine the outcomes of cases converted from an external fixator to an internal fixation device in the management of limb reconstructions and deformity corrections. A retrospective review of 18 patients, that underwent a conversion procedure to internal fixation following long term external fixation use, was done. This comprised 24 limbs. Inclusion criteria: All cases of long term external fixator use converted to internal fixation over a 5 year period. Average external fixation time, pin site care, conversion timing, surgical device used as well as outcome were documented.Purpose of the study:
Method:
Is circular external fixation a safe and effective method of managing closed distal third tibia fractures. These fractures are conventionally treated with plaster casts, intramedullary nails or plate fixation. These treatment modalities have complication rates in the literature of up to 16% malunion, 12% non-union, and 17% deep infections. Retrospective review of 18 patients with closed distal third tibia fractures, with or without extension into the ankle joint, treated with circular fixator systems and minimal percutaneous internal fixation of the intra-articular fragment if required. Patients were followed up for time to union, malunion incidence as well as incidence of pin tract and deep infection. Distal third fractures which were extra articular or with simple intra articular extension were included. (AO 43 A, B1, C1, C2 + AO 42 in distal third) Patients with pilon fractures (AO 43 B2, B3 and C3) were excluded.Purpose of the study:
Description and Methods:
This study attempts to establish whether biomechanical manipulation through distraction can result in fracture union. A retrospective clinical audit of 15 patients with delayed or hypertrophic non-unions treated successfully with closed distraction in circular external fixation. Average time to union, complications and complication rates were also reviewed. Inclusion criteria: all patients with delayed or hypertrophic non-union, treated by closed distraction between 2004 and 2011.Purpose:
Method:
To determine whether HIV seropositivity is a significant risk factor for infection following open fractures of long bones, we undertook a prospective cohort-type analytical study. We obtained Ethics Committee approval and invited suitable patients (adults with open fractures of long bones) presenting to our institution to participate in the study. Written informed consent was obtained and the patient registered. Baseline blood tests were done (Hb, HIV, Albumin, CD4 count), after which treatment proceeded in the standard manner. At set intervals, patient records were accessed and information captured in a database. Patients were followed up until bony union had occurred. To date, 50 patients have been recruited to the study. Of these, 19 were followed up until bony union. All but one of these patients was male and the mean age was 34.5 years. Fractures included three femora, two humeri, two radii and 15 tibiae. There were five Gustilo-Anderson grade-I, seven grade-II, six grade-IIIa and three grade-IIIb open fractures. Three of the 19 patients tested positive for HIV (15.8%). Infection occurred in five patients (26.3%), none of whom was HIV-positive. The strongest predictor for infection was the time delay to wound inspection, with mean delays of 56.9 hours and 100.2 hours respectively in patients who did and did not develop infection. Although our study is small, it suggests that asymptomatic HIV seropositivity is not a significant risk factor for infection following open fractures of long bones. Delayed wound inspection puts patients at increased risk.
