EXTERNAL FIXATION WITH THE ORTHOFIX SYSTEM IN DISLOCATED FRACTURES OFTHE LOWER-EXTREMITIES IN CHILDREN

Eighteen children with dislocated fractures of the tower extremities w ere operated on with a dynamic axial unilateral external fixator, the Orthofix system. Telescopic facility allows easy conversion from rigid to dynamic fixation. Seven girls and 11 boys with an average age of 1 1 3/4 years were treated. The material comprised 10 femoral and nine t ibial fractures (one girl had both fracture types). Average follow-up of these children was 19 months. Closed reduction was possible in 11 c ases, and eight fractures were treated by open reduction. Physiotherap y for the adjacent joints was started on the second postoperative day. In 14 of the 18 patients, partial weight-bearing crutches was also st arted at this time. Average hospital stay was 13 days. At the first ra diographic indication of periosteal callus, dynamic loading was starte d. Removal offered as an outpatient procedure, was performed after an average time of 9 weeks. In one case, pin-tract-infection developed, r equiring deep soft tissue revision. No pin hole loosening, chronic inf ection, non-union, and or malalignment occurred. For all patients, we achieved an overall success rate of < 10-degrees angular deviation, < 1.5 cm leg length discrepancy and full range of associated joint movem ents.