ArticleInternational orthopaedics2019
External fixation for primary and definitive management of open long bone fractures: the Syrian war experience.
Article in International orthopaedics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 51 citations in OpenAlex.
- Locking compression plate fixation versus intramedullary nailing of humeral shaft fractures: which one is better? A single-centre prospective randomized study.International orthopaedics · 2020Trial
- Application of axial load-share ratio testing technology in the bone transport treatment of large segmental tibial bone defects.BMC musculoskeletal disorders · 2026Article
- Epidemiology of civilian patients with acute conflict-related extremity injuries sustained in Syria and Iraq.PLOS global public health · 2026Article
- Effect of Screw Distribution on Stability and Interfragmentary Strain of Lower Tibial Fractures: A Finite Element Analysis.Current medical science · 2025Article
- Carefix hexaxial spatial frame versus Ilizarov circular external fixator in treating high-energy tibial shaft fractures: a retrospective study.BMC musculoskeletal disorders · 2025Article
- Peripheral extremity surgery performed during the Syrian conflict - A scoping review.PLOS global public health · 2025Article
- Utility of 2.0 mm diameter Kirschner wires assembled with Wu's Tension Traction Bows in calcaneal skeletal traction.Scientific reports · 2024Article
- External Fixation as a Primary and Definitive Treatment for Complex Tibial Diaphyseal Fractures: An Underutilized and Efficacious Approach.Orthopedic research and reviews · 2024Article
- Transport over a flexible nail to treat a tibial defect caused by shelling injury: A case report of a 13-year-old child.International journal of surgery case reports · 2023Article
- Does intramedullary elastic nail augmentation increase resistance to bending stress in plate fixation of long bones? A biomechanical study on lamb cadaveric femurs.Joint diseases and related surgery · 2023Article
- Effectiveness and Biomechanical Analysis of the Ortho-Bridge System on Femoral Fracture Healing: A Retrospective Analysis.Indian journal of orthopaedics · 2022Article
- Medical aid to war victims in Syria in 2019: a report of organized healthcare support from a charity organization.BMC health services research · 2022Article
- [Treatment of Gustilo-AndersonZhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2022Article
- Retrospective clinical outcomes in the definitive treatment of high-energy tibial diaphyseal fractures using hexapod external fixator versus monolateral external fixator.BMC musculoskeletal disorders · 2022Article
- Low-cost locally manufacturable unilateral imperial external fixator for low- and middle-income countries.Frontiers in medical technology · 2022Article
- Unilateral External Fixator Combined with Lateral Auxiliary Frame for Ultimate Treatment of Tibia and Fibula Shaft Fractures with Poor Soft Tissue Conditions.BioMed research international · 2022Article
- Locally developed external fixators as definitive treatment of open tibia diaphyseal fractures: a clinical prospective study conducted in Ivory Coast.International orthopaedics · 2022Article
- Conflict-related health research in Syria, 2011-2019: a scoping review for The Lancet - AUB Commission on Syria.Conflict and health · 2021Article
- Bony callus stiffness indirectly evaluated by the axial load-share ratio in vivo as a guide to removing a monolateral external fixator safely.International orthopaedics · 2021Article
- Application of unilateral external fixation by the "joystick technique" in the treatment of pediatric tibia shaft fractures: technical note.Journal of orthopaedic surgery and research · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo report on the experience of one field hospital in using external fixation as a primary and definitive treatment for open long bone fractures during the Syrian war.
methodsA total of 955 patients with open long bone fractures (femur, tibia, humerus) who were operated and followed up at a field hospital in Aleppo, Syria, from 2011 to 2016, were retrospectively reviewed. Different types of uniplanar and some multiplanar external fixators were used solely as a primary and definitive tool until bone union was achieved. Union rate and infection rate were reported in association with age, gender, Gustilo/Anderson classification, type of fixator, and presence of neurovascular injuries.
resultsOut of 955 patients, 404 (42.3%) continued to follow up until bone union or until removal of the external fixator. The average age was 27.5 ± 11 years, with 91.6% males and 8.2% females. The overall union rate was 68.3% (276/404), with 60.9% (95/156) in open femur, 70.3% (137/195) in open tibia, and 83% (44/53) in open humerus fractures. The overall infection rate was 16.7% (67/401), with 18.6% in open femur, 18.1% in open tibia, and 5.8% in open humerus fractures.
conclusionThe use of external fixation for definitive treatment of open long bone shaft fractures caused by high energy trauma during times of wars or conflicts is reliable and should be used in early frontline intervention and in areas with limited access to resources.
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