External Fixation in Lower Extremity Trauma: Cook County Experience

Abstract

At Cook County Hospital, before 1973, pins and plaster were the only components of external fixation for the treatment of certain acute tibial and femoral fractures. Our first experience with a commercially available device was with the original AO external fixator. It was used for an infected nonunion following an open tibial fracture. Subsequently, it became the external fixation device of choice for almost all open fractures in lower extremities. The reason for using the AO external fixator was its low cost. In our institution, replacement of such devices is difficult and their loss is not uncommon: when patients are transferred out or go for follow-up elsewhere; when rods are abused and bent, removed and lost; or when they have been discarded after being used three to four times. Other devices are much more expensive. Over the years, external fixation in lower extremities was used for a number of indications.