Addition of a kickstand to unilateral external fixators

Abstract

Traumatic fractures, ligamentous injuries, and dislocations of the lower extremities often require two-staged protocols with initial external fixation and delayed internal fixation. Bone stability, joint congruency, and decreased swelling of the surrounding soft tissue are achieved prior to definite fixation. Unilateral (also known as monolateral) or bilateral external fixators can be used for temporary fixation depending on the character and stability of the fracture. The heel is vulnerable to pressure. Patients in intensive care units who have multiple fractures with severe traumatic head and brain injury, including compromised protective reflexes as well as diabetic trauma patients are at risk for pressure-related heel ulcers. Here we describe a modification of a unilateral external fixator for lower extremity injuries by adding a kickstand to prevent heel ulcers. This modification not only reduces ulcers, their complications, and related treatment costs but also improves the outcome for the patient.