Hybrid Fixation for Paediatric Femoral Supracondylar Fracture during Circular External Fixation of the Lower Limb

Abstract

A bstract Aim To describe the novel hybrid fixation technique for paediatric femoral supracondylar fracture during circular external fixation of the lower limb. Background The Ilizarov external fixator is commonly used for various orthopaedic conditions. Difficulties associated with external fixation have previously been described. A fall while using a circular external fixator can cause ipsilateral fracture. Such fractures are ideally treated conservatively, but it is difficult to fix the frame itself. No study has reported the treatment of paediatric femoral supracondylar fracture during circular external fixation. Herein, we describe a novel hybrid fixation technique that was successfully used to treat paediatric femoral supracondylar fracture in three paediatric patients with circular external fixators. Technique The fracture was manually manipulated and reduced by slight hyperextension of the lower extremity under general anaesthesia. After confirmation of good reduction, a stockinette, a cast padding, and a thin core cast were applied to the ipsilateral thigh. The hinge parts were attached to the medial and lateral sides of the proximal ring. The rods were connected to the medial and lateral hinges, and the half ring was connected to the ventral side of the proximal end. Under fluoroscopic confirmation, the thin core cast of the thigh and rods were connected by cast rolled in a figure-of-eight manner. The hinges were locked with the knee joint slightly flexed. Conclusion The minimally invasive hybrid fixation technique enables conservative treatment of paediatric femoral supracondylar fracture during circular external fixation of the lower limb with no complications, and early exercise and recovery. Clinical significance This novel hybrid fixation technique will be an effective method for paediatric femoral supracondylar fracture in patients with a circular external fixator. How to cite this article Oka Y, Kim W-C, Yoshida T, et al. Hybrid Fixation for Paediatric Femoral Supracondylar Fracture during Circular External Fixation of the Lower Limb. Strategies Trauma Limb Reconstr 2020;15(3):179–183.

Management algorithm of external fixation in lower leg arterial injury for limb salvages

“…The use of external fixation can yield excellent stability to allow the vascular repair to be performed in a controlled environment to protect the completed vascular repair from disruption [ 5 ]. Nevertheless, the current research paid more attention to the complex lower extremity deformity correction [ 6 – 9 ], the modification for external fixation [ 10 – 12 ] or case report of the use of external fixators in fractures [ 11 ]. However, according to our knowledge, to date, there has been no published work regarding the outcome of the treatment of external fixators in lower extremity arterial injuries.…”