Osteosynthesis and Trauma Care 2005; 13(4): 261-263
DOI: 10.1055/s-2005-875480
Original Article

© Georg Thieme Verlag Stuttgart · New York

A Simple Technique of Outpatient Clinic Removal of External Fixators Using a Topical Cryorefrigerant Anesthetic

R. K. Owens1 , D. Parameswaran1 , D. Seligson1 , C. S. Roberts1
  • 1Department of Orthopaedic Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
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Publikationsverlauf

Publikationsdatum:
01. Dezember 2005 (online)

Abstract

The purpose of our study was to assess patient satisfaction with office removal of external fixators using a topical cryorefrigerant anesthetic spray. Twenty-two subjects were selected in a non-randomized fashion and twenty-one subjects completed the study. After IRB approval, a prospective study was performed of patients presenting to the orthopaedic clinic for removal of an external fixator. Informed consent was obtained and patients completed a visual analogue score and simple questionnaire which included anticipated pain both before removal, pain experienced after fixator removal, and overall patient satisfaction. A topical anesthetic spray was used at the pin-skin junction prior to removal of the half-pins. There were 17 males and 4 females, average age 38.3 years, whose fixators had been in place for 6.6 weeks (range, 3.5 to 20 weeks) for the following injuries: distal radius fractures (11), pelvic ring injuries (4), tibial plateau fractures (2), pilon fracture (1), tibia-fibula fracture (1), elbow fracture (1), and mid-foot injury (1). The average time it took to remove the fixator was 7.7 minutes. Twenty-nine percent of patients anticipated no pain at all from fixator removal. The average pain score after fixator removal was 42 % of maximum. Thirty-three percent had no pain from fixator removal. Eighty-nine percent of patients were satisfied with the procedure. External fixators can be comfortably and safely removed in the outpatient clinic using a topical cryorefrigerant anesthetic spray.

References

  • 1 Behrens F, Searls K. External fixation of the tibia. Basic concepts and prospective evaluation.  J Bone Joint Surg [Br]. 1986;  68 246-254
  • 2 DiCicco J D, Ostrum R F, Martin B. Office removal of tibial external fixators: an evaluation of cost savings and patient satisfaction.  J Orthop Trauma. 1998;  12 569-571
  • 3 Edwards G S. Intra-articular fractures of the distal part of the radius treated with the small AO external fixator.  J Bone Joint Surg [Am]. 1991;  73 1241-1250
  • 4 Gershuni D H, Halma G. The A-O external fixator in the treatment of severe tibia fractures.  J Trauma. 1983;  23 986-990
  • 5 Howard P W, Stewart H D, Hind R E. et al . External fixation or plaster for severely displaced comminuted Colles' fractures? A prospective study of anatomical and functional results.  J Bone Joint Surg [Am]. 1989;  71 68-73
  • 6 Huskisson E C. Visual analog scales. In: Melzack R (ed). Pain Measurements and Assessment. Raven Press, New York 1983; 33-37
  • 7 Kellam J F. The role of external fixation in pelvic disruptions.  Clin Orthop. 1989;  241 66-82
  • 8 Price D D, McGrath P A, Rafii A. et al . The validation of visual analog scales as ratio scale measures for chronic and experimental pain.  Pain. 1983;  17 45-56
  • 9 Tornetta P, Weiner L, Bergman M. et al . Pilon fractures: treatment with combined internal and external fixation.  J Orthop Trauma. 1993;  7 489-496

Craig S. RobertsM. D. 

Department of Orthopaedic Surgery · University of Louisville

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Louisville, KY 40202

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