Retrospective analysis on use of external fixation in pediatric extremity trauma and fractures as a damage control device and their outcome in a tertiary care set up

Abstract

Most of the fractures in children and adolescents are treated conservatively with Plaster of Paris casts, traction. Those requiring operative intervention are managed with K wires, elastic nails and plates. External fixation is used only in open fractures, vascular injuries, polytrauma patients and burns.Methods: This is a retrospective analysis of the children records who underwent external fixation of their fractures for various reasons to find out those reasons and the bones which were fixed externally, and the results of external fixation with respect union and any complications. Results: Twenty eight patients including 19 males (68%), age between 6 and 14 yrs average age 9.64 years were treated from 2013 to 2018. A total of thirty five fractured areas were present which included ten femur fractures, nineteen tibial fractures, five patients had vascular repairs. Union rate 100%, average time to union 10.84 weeks. One refracture femur, one varus and valgus malunions of distal tibia, one grade 4 pin tract infection, on shortening and one lengthening both less than 2cms. Conclusions: External fixation in pediatric trauma is rather a compulsion than a choicest treatment modality, in view of hemodynamic instability, multiple injuries, open fractures and vascular injuries but with acceptable rates of union and complications.