Article

The timing of definitive fixation for major fractures in polytrauma patients is
controversial. We investigated the outcome of the Sheffield hybrid system (SHF)
as a solution in the role of primary and definitive fixator for patient with open
femoral fractures in whom definitive osteosynthesis with intramedullary nail can
be associated with higher rate of complications. Eleven patients
(7 men and 4 women), mean age of 40.4 years (range 14-75 years) with previous injury severity
score (ISS) greater than or equal to 16 were treated from a damage control
orthopedics perspective. Time in the fixator averaged 28 weeks (range 10-64
weeks). Mean follow-up was 3 years (2-4.5). All fractures united. Paley
functional and bone results in most cases were good to excellent. Final mean knee
range of motion was 113 degrees. We found that SHF for complex fractures of the
femur combine maximum support for the bone and preservation of soft tissues. SHF
is an effective technique compared to internal nails and earlier external fixator
devices, attributable to its advantages such as continuity
of frame till union,
preventing any second-hit phenomenon, early mobilization, and restoration of
primary defect due to bone loss by differential distraction osteogenesis without
additional surgery.

Langue : ANGLAIS