Temporising external fixation for hind foot trauma
Keywords:
Temporizing, External, Fixation, Outcome, Ankle, Pilon, FractureAbstract
Objective: The use of temporizing external fixation for distal tibia and ankle fracture not in the damage control set-up is debatable. The current paper highlights the outcome of this practice.
Methods: Fifteen patients treated for isolated ankle, Pilon and distal tibial fracture with a temporising external fixation in Scarborough York teaching hospital were included in this study. The fixator became a definitive fixation in three patients. Hoffman triangular bar technique was used.
Results: Mazur clinical rating was used on follow-up at a mean follow-up of 13 months. The outcome was excellent (1), good (4), fair (6), poor (3). Loss of reduction, pin tract infection, union problems were some of the complication. The overall complication outweighs the benefits using temporising external fracture in the isolated hind foot trauma. The swelling and blister of the soft tissue can be treated otherwise with elevation and plaster immobilization without the justification for using the external fixation.
Conclusion: The use of temporising external fixation in hind foot ankle fracture(s) has to be justified; as ultimate conversion to internal fixation when expertise available and the swelling settles, is associated with poor to fair outcome in more than half of the cases. Every attempt should be made to intervene before the swelling starts, with accurate internal fixation performed by an experienced surgeon.
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