An audit of circular external fixation usage in a tertiary hospital in South Africa

dc.contributor.authorVan der Walt, Nicoen_ZA
dc.contributor.authorFerreira, N.en_ZA
dc.date.accessioned2020-03-18T09:49:17Z
dc.date.available2020-03-18T09:49:17Z
dc.date.issued2018
dc.descriptionCITATION: Van der Walt, N. & Ferreira, N. 2018. An audit of circular external fixation usage in a tertiary hospital in South Africa. SA Orthopaedic Journal, 17(4):4-21, doi:10.17159/2309-8309/2018/v17n4a1.
dc.descriptionThe original publication is available at http://journal.saoa.org.za/index.php/saoj
dc.description.abstractBackground: Circular external fixation is a well-known treatment modality in reconstructive orthopaedic surgery and is frequently used for deformity correction, limb lengthening, limb salvage, and complex diaphyseal and periarticular fractures. The current use of this treatment modality in the South African context remains largely unknown. This retrospective review aims to describe the indications, outcomes and complications of the use of circular external fixation in a tertiary hospital in South Africa. Materials and methods: We retrospectively reviewed the records of 480 patients treated with circular external fixation in a specialist limb reconstruction unit. We report on patient demographics, comorbidities, indications and outcomes. Results: The final cohort consisted of 346 men and 134 women with a mean age of 35.5 years (SD 14.9, range: 5–73). Comorbidities were identified in 163 (34.0%) patients. These included diabetes in 14 (2.9%) patients and smoking in 102 (21%) patients. HIV infection was diagnosed in 120 patients (25%) with a mean CD4 count of 425 cells/mm3 (SD: 223, range: 82–1056). The mean time in external fixator was 24.6% weeks (SD: 15.3, range 4–159). The treatment objective was achieved in 441 patients (92%). The overall complication rate excluding pin-site infection was 26%. Pin-site infection occurred in 88 patients (18.3%) but had no impact on the outcome of treatment. Conclusion: Circular external fixation treatment objectives can be achieved in a high percentage of patients in the context of a South African specialist reconstruction unit. This study shows favourable outcomes in deformity correction, limb lengthening, limb salvage, and complex diaphyseal and periarticular fractures. Comorbid factors, including HIV, diabetes and smoking had no effect on achieving the planned outcomes, but smoking did increase the overall time in external fixator.en_ZA
dc.description.urihttp://journal.saoa.org.za/index.php/saoj/article/view/268
dc.description.versionPublisher's version
dc.format.extent8 pagesen_ZA
dc.identifier.citationVan der Walt, N. & Ferreira, N. 2018. An audit of circular external fixation usage in a tertiary hospital in South Africa. SA Orthopaedic Journal, 17(4):4-21, doi:10.17159/2309-8309/2018/v17n4a1
dc.identifier.issn2309-8309 (online)
dc.identifier.issn1681-150X (print)
dc.identifier.otherdoi:10.17159/2309-8309/2018/v17n4a1
dc.identifier.urihttp://hdl.handle.net/10019.1/107636
dc.language.isoen_ZAen_ZA
dc.publisherSouth African Orthopaedic Associationen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectFixation (Histology)en_ZA
dc.subjectBone wiring (Orthopedics)en_ZA
dc.subjectOrthopedic surgeryen_ZA
dc.titleAn audit of circular external fixation usage in a tertiary hospital in South Africaen_ZA
dc.typeArticleen_ZA
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