• G Taeger, S Ruchholtz, R Zettl, C Waydhas, and D Nast-Kolb.
• Klinik und Poliklinik für Unfallchirurgie, Universität Essen, Hufelandstrasse 55, 45122 Essen. georg.taeger@uni-essen.de
• Unfallchirurg. 2002 Apr 1; 105 (4): 315-21.

Aim Of StudyIt is the purpose of the current investigation to determine whether immediate external fixation of fractures, which is a simple and fast procedure, followed by secondary planned conversion represents a safe and reliable procedure without additional trauma in multiply injured patients (ISS > 15).MethodsWith a prospective protocol, all data of multiply injured patients with fractures which required immediate osteosynthesis were registrated. Demographic data, severity of injury (AIS and ISS), data of primary surgery and osteosyntheses, course of intensive care (organ failure, local/systemic complications, infectious protocol), secondary conversion (time, duration, osteosynthesis related complications) and further course were analysed.ResultsOut of 679 mulitiply injured patients (ISS 22), 118 required immediate surgical procedures for intracranial injury and 175 for further indications. In 45 multiply injured patients (ISS 37), 83 external fixations were performed. According to 59 planned secondary conversions (13 days), one patient developed deep infection, no other local complication was registrated. The average time for conversion procedures lasted three times longer as in immediate external fixation (43 vs. 139 min).ConclusionsImmediate external fixation in multiply injured patients is fast and poor of complications. It is a expedient procedure which is safe and careful for critically ill patients. The required conversion procedure shows no raised rate of complications.

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