INTERFERENCE OF EXTERNAL DAMAGE CONTROL FIXATION IN DEFINITIVE OSTEOSYNTHESIS

ABSTRACT Introduction: Indications for provisional external fixation prior to the definitive treatment of fractures are associated with the control of local and systemic damage and the impossibility of definitive osteosynthesis in the emergency. Objective: To identify complications associated with external fixation prior to definitive internal osteosynthesis. Methods: This is a comparative, prospective study (Level II). Inclusion criteria: patients treated as emergencies (November 2019 and March 2020) who underwent provisional external correction followed by definitive osteosynthesis. We look for signs of inadequacies in external correction and correlation with infections (erythema, hyperemia, fistulae in the path of the pins or surgical scars), systemic symptoms of infection, and radiographic parameters for treatment up to eight weeks after surgery. Results: The average time for conversion to definitive osteosynthesis was 15.9 days and 47 lower limbs and three upper limbs were fixed. Of the participants who had deep infections, three (6%) showed signs during initial treatment (external fixator) and nine (18%), after definitive internal osteosynthesis. We found no correlation between provisional external correction and complications in the definitive treatment with osteosynthesis. Conclusion: The use of temporary external fixation before definitive internal osteosynthesis in fractures of the appendicular skeleton failed to increase complication rates even if the path of the implants in both procedures overlapped. Level of Evidence II, Comparative Prospective Study.

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Main Authors: MUSSATTO,JULIO CESAR DO AMARAL, BALSIMELLI,FERNANDO, MUSSATTO,GUILHERME DO AMARAL, ZAMBONI,CAIO, CHRISTIAN,RALPH WALTER, MERCADANTE,MARCELO TOMANIK
Format: Digital revista
Language:English
Published: ATHA EDITORA 2022
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-78522022002400209
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spelling oai:scielo:S1413-785220220024002092022-08-22INTERFERENCE OF EXTERNAL DAMAGE CONTROL FIXATION IN DEFINITIVE OSTEOSYNTHESISMUSSATTO,JULIO CESAR DO AMARALBALSIMELLI,FERNANDOMUSSATTO,GUILHERME DO AMARALZAMBONI,CAIOCHRISTIAN,RALPH WALTERMERCADANTE,MARCELO TOMANIK Infections. External Fixators. Fracture Fixation Internal ABSTRACT Introduction: Indications for provisional external fixation prior to the definitive treatment of fractures are associated with the control of local and systemic damage and the impossibility of definitive osteosynthesis in the emergency. Objective: To identify complications associated with external fixation prior to definitive internal osteosynthesis. Methods: This is a comparative, prospective study (Level II). Inclusion criteria: patients treated as emergencies (November 2019 and March 2020) who underwent provisional external correction followed by definitive osteosynthesis. We look for signs of inadequacies in external correction and correlation with infections (erythema, hyperemia, fistulae in the path of the pins or surgical scars), systemic symptoms of infection, and radiographic parameters for treatment up to eight weeks after surgery. Results: The average time for conversion to definitive osteosynthesis was 15.9 days and 47 lower limbs and three upper limbs were fixed. Of the participants who had deep infections, three (6%) showed signs during initial treatment (external fixator) and nine (18%), after definitive internal osteosynthesis. We found no correlation between provisional external correction and complications in the definitive treatment with osteosynthesis. Conclusion: The use of temporary external fixation before definitive internal osteosynthesis in fractures of the appendicular skeleton failed to increase complication rates even if the path of the implants in both procedures overlapped. Level of Evidence II, Comparative Prospective Study.info:eu-repo/semantics/openAccessATHA EDITORAActa Ortopédica Brasileira v.30 n.4 20222022-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-78522022002400209en10.1590/1413-785220223004e250322
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libraryname SciELO
language English
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author MUSSATTO,JULIO CESAR DO AMARAL
BALSIMELLI,FERNANDO
MUSSATTO,GUILHERME DO AMARAL
ZAMBONI,CAIO
CHRISTIAN,RALPH WALTER
MERCADANTE,MARCELO TOMANIK
spellingShingle MUSSATTO,JULIO CESAR DO AMARAL
BALSIMELLI,FERNANDO
MUSSATTO,GUILHERME DO AMARAL
ZAMBONI,CAIO
CHRISTIAN,RALPH WALTER
MERCADANTE,MARCELO TOMANIK
INTERFERENCE OF EXTERNAL DAMAGE CONTROL FIXATION IN DEFINITIVE OSTEOSYNTHESIS
author_facet MUSSATTO,JULIO CESAR DO AMARAL
BALSIMELLI,FERNANDO
MUSSATTO,GUILHERME DO AMARAL
ZAMBONI,CAIO
CHRISTIAN,RALPH WALTER
MERCADANTE,MARCELO TOMANIK
author_sort MUSSATTO,JULIO CESAR DO AMARAL
title INTERFERENCE OF EXTERNAL DAMAGE CONTROL FIXATION IN DEFINITIVE OSTEOSYNTHESIS
title_short INTERFERENCE OF EXTERNAL DAMAGE CONTROL FIXATION IN DEFINITIVE OSTEOSYNTHESIS
title_full INTERFERENCE OF EXTERNAL DAMAGE CONTROL FIXATION IN DEFINITIVE OSTEOSYNTHESIS
title_fullStr INTERFERENCE OF EXTERNAL DAMAGE CONTROL FIXATION IN DEFINITIVE OSTEOSYNTHESIS
title_full_unstemmed INTERFERENCE OF EXTERNAL DAMAGE CONTROL FIXATION IN DEFINITIVE OSTEOSYNTHESIS
title_sort interference of external damage control fixation in definitive osteosynthesis
description ABSTRACT Introduction: Indications for provisional external fixation prior to the definitive treatment of fractures are associated with the control of local and systemic damage and the impossibility of definitive osteosynthesis in the emergency. Objective: To identify complications associated with external fixation prior to definitive internal osteosynthesis. Methods: This is a comparative, prospective study (Level II). Inclusion criteria: patients treated as emergencies (November 2019 and March 2020) who underwent provisional external correction followed by definitive osteosynthesis. We look for signs of inadequacies in external correction and correlation with infections (erythema, hyperemia, fistulae in the path of the pins or surgical scars), systemic symptoms of infection, and radiographic parameters for treatment up to eight weeks after surgery. Results: The average time for conversion to definitive osteosynthesis was 15.9 days and 47 lower limbs and three upper limbs were fixed. Of the participants who had deep infections, three (6%) showed signs during initial treatment (external fixator) and nine (18%), after definitive internal osteosynthesis. We found no correlation between provisional external correction and complications in the definitive treatment with osteosynthesis. Conclusion: The use of temporary external fixation before definitive internal osteosynthesis in fractures of the appendicular skeleton failed to increase complication rates even if the path of the implants in both procedures overlapped. Level of Evidence II, Comparative Prospective Study.
publisher ATHA EDITORA
publishDate 2022
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-78522022002400209
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