Complications after use of extracortical clamp device in combined and consecutive external and internal fixation of femoral bone

Introduction. Extracortical Clamp Device (ECD) is a tool that, unlike conventional wires and pins, does not perforate long bone cortex. Therefore, its use simplifies methods of combined and consequtive use of internal and external fixation, osteosynthesis in periprosthetic fractures and deformities. Purpose of the study - to compare the rate of complications and their structure depending on extracortical clamp device application and conventional transosseous elements in combined external fixation of femur. Materials and methods. We analyzed the complications arising in treatment of 66 patients with frames where ECD were used (group «ECD»). The results were compared with the results of treatment 29 patients, when utilizing combination of external and internal fixation, external fixation device included conventional transosseous elements only (group «W-P»). Results. In the group «ECD» inflammation of the soft tissues around fixing elements was identified in 14.8% of cases. In these patients complication arisen at 45.5% of the all used fixing elements; of them - 18.2% around ECD. In the group «W-P» pin-tract infection occurred in 29.2% cases. ECD breaking was in one case (3.7%) breaking of wires or pins in «W-P» group was diagnosed in 3 cases (13.6%). In the treatment of periprosthetic fractures and deformities with ECD soft tissues around fixing elements was in 16.7% of cases. In the treatment of similar fractures and deformities without prosthesis pin-tract infection were diagnosed in 21.5% cases. All of these complications did not affect the outcome. Other complications (neuropathy, contracture of the knee) were not depending on the application of ECD.

extracortical clamp device, external fixation complications, femoral defects and deformities, lengthening over the nail, bone transport over nail