Duration of External Fixation
In order to limit complications when using external fixation, it is an option to limit the duration of fixation.
Rationale
Three prospective studies met the inclusion criteria. These studies, collectively, do not agree upon a length of immobilization and we chose not to define a specific duration. The first study demonstrated no significant difference in groups treated with external fixation for 5 weeks as compared to 3 weeks of external fixation and 2 weeks of additional casting.85 The results were reported using a non-validated patient outcome score, hence no clear effect could be demonstrated by the early discontinuation of the external fixation. Two additional studies using a non-validated patient outcome score showed a statistically significant association between outcomes and prolonged external fixation.86, 87 Based on limitations of the outcome instruments, the strength of recommendation was graded as “Limited.”
- (85) Haddad M, Jacoby B, Snerum L, Hede J, Overgaard S. External fixation of distal radial fractures: 3 or 5 weeks of external fixation. Int Orthop 2000;24(4):224-226.
- (86) Kaempffe FA, Wheeler DR, Peimer CA, Hvisdak KS, Ceravolo J, Senall J. Severe fractures of the distal radius: effect of amount and duration of external fixator distraction on outcome. J Hand Surg [Am] 1993;18(1):33-41.
- (87) Kaempffe FA, Walker KM. External fixation for distal radius fractures: effect of distraction on outcome. Clin Orthop Relat Res 2000;(380):220-225.