ACTA FAC. MED. NAISS. 2007; 24 (1): 21-26

   Original article

Predrag Stojiljkovic¹, Zoran Golubovic¹, Desimir Mladenovic¹, Ivan Micic¹, Sasa Karalejic¹ , Igor Kostic², Slobodan Milenković²

   

¹Clinic of Orthopedics and Traumatology, Clinical Center Nis
²Orthopedic Department of the Health Centre Vranje

External fixation has not been widely used for femoral shaft fractures. External fixation is generally reserved for severe open fractures and for initial stabilization of fractures in polytrauma patients. From January 1, 2000 to December 31, 2005, 23 patients with 24 femoral shaft fractures were treated by external fixator Mitkovic. The series included 19 (83%) men and 4 (17%) women, mean age 35.9 years. All patients were victims of high-energy trauma: 16 (70%) traffic accidents, 3 (13%) falls fromheight and 4 (17%) firearm wounds. Fourteen (61%) patients had multiple injuries. One patient had bilateral femoral shaft fractures and three patients had another fracture in the lower extremity. Fourteen (58.3%) fractures were open. Sixteen fractures (66.6%) had comminution. Twenty-one fractures (87.5%) healed without complication including five fractures where external fixation was converted into internal one. The mean time to union was 6.5 (4-9) months. There were two pin-track infections (8.3%), two deep infections (8.3%), and only one nonunion (4.1%). The femur length was equal to the healthy side in 19 cases, and was shorter by 1-2 cm in 5 cases. Mean active knee flexion was 90° (40-130°). Knee flexion was more than 110° in 9 (39.1%) patients. External fixation by the use of Mitkovic external fixator is a useful technique for the stabilization of severe open and close highly comminuted femoral shaft fractures until union. It is also a safe procedure to achieve temporary rigid stabilization of femur fracture in too critical polytrauma patients before delayed internal fixation (damage control orthopedics).

Key words: femoral shaft fracture, external fixation, external fixator Mitkovic