external fixation

Indications

Deformity correction

EMST / ATLS Principles

Usually polytrauma

- 10% mortality

Aims

1. Volume replacement

2. Reduce pelvic ring

3. Stop exsanguination

- external stabilisation / surgery / embolisation

Associated Local Injuries

Arterial bleeders

Epidemiology

Usually young patients

- 15 - 40

15% compound

Aetiology

High velocity injury

- MBA

- MVA

- pedestrian v car

- fall from height

Emergency Managment

EMST principles

- need for transfusion not uncommon

Issues

Like elbow arthrodesis, knee arthrodesis is an option of last resort

Example

- cannot sit on airplane toilet with door closed

Aims

Coapt 2 coplanar cancellous surfaces under compression with rigid fixation

Indications

Septic arthritis

Salvage failed TKR / infected TKR

Tumour

Charcot Join

PFFD