The use of external fixator in the management of gunshot related open limb fractures

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The Use Of External Fixator In The Management Of Gunshot Related Open Limb Fractures

Objective: To review our experience on the use of external furators in the management of open limbs' fractures caused by gunsnot at Panzi Hospital over the last 4 years. Patients and Methods: This retrospective study was done at Panzi Missionary Hospital located in Bukavu,Democratic Republic of Congo. External fixators were applied in 62 patients affected by limb war injuries with fracture. Upon admission patients were evaluated, stabilized and submitted to basic preoperative investigations. Under general, spinal or regional anaesthesia a wound exploration and debridement was performed followed by fracture stabilization with external fixators. These devices were removed and replaced by POP casts once soft tissue injuries had healed. Physiotherapy was started as early as 2nd post-operative days. Results: A total of 17 complications were recorded. They included 2 cases of pseudoarthrosis, 10 osteitis, 4 limb gangrene and 1 tetanus case. Only 2 (pseudoarthrosis) could, possibly, relate to the use of external fixators and healed afier bone graft. One patient died (the one who developed tetanus). Conclusions: External ftrators can be quite helpful in experienced hands in selected cases of war wounds of the limbs with fracture