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Conversion From External Fixation to Definitive Fixation: Periarticular Injuries

Dr. Carmack is Medical Director, Orthopaedic Trauma Surgery, Eastern Maine Medical Center, Bangor, ME.

Neither Dr. Carmack nor the department with which he is affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article.

The opinions expressed herein are those of the authors and are not necessarily representative of those of the Department of Defense (DOD), or the United States Army, the United States Navy, or the United States Air Force.

Extremity injuries sustained by uniformed service combatants pose a significant challenge to military orthopaedic surgeons. The wounding mechanisms in Operation Iraqi Freedom and Operation Enduring Freedom consist of blasts, penetrating injuries, and blunt injuries. The mortality of warriors has decreased overall because of the improvements in head, neck, and torso body armor. Consequently, the severity of extremity wounds has increased. Because of the far-forward surgical assets (surgeons and advanced equipment), these patients are stabilized rapidly and their injured extremities are treated early (ie, revascularized, débrided, stabilized). However, multiple challenges exist in the timing of definitive reconstructive efforts once these injured service members return to military medical centers in the continental United States.

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