Richard C. Echem^1,, Phillip D. Eyimina¹, Vincent U.E. Adiela¹, Tamunokuro Diamond¹

Background: External fixation is an important modality in fracture management. It is a method that utilises a combination of pins, wires, clamps and bars or rings. Clamps link a pin or wire to a rod or ring. Sometimes all the components of an external fixator may not be available and there will be need to improvise. Aim: To document the use of a synthetic cast as an improvised external fixator clamp in open fracture management. Methods: A prospective study of consecutive patients with open extremity fractures at the University of Port Harcourt Teaching Hospital, Port Harcourt from October 2012 to October 2017. A synthetic cast was utilised either partially or wholly as clamps for external fixation. The patients’ sociodemographics and information relevant to the injury were obtained. Data was analysed using SPSS version 23. Results: Twenty-eight patients were managed with improvised clamp. Ages ranged from 16 to 47 years, consisting of 18 males and 10 females. Majority resulted from road traffic crashes. There were three humeral and 25 tibial fractures with majority being in the middle third. Majority were Gustilo type IIIB. Twenty-five fractures united although two of these were malunited. One had non-union. Other complications were delayed union and pin tract infection. Two patients had below knee amputation for gangrene. Duration of hospital stay ranged from 26 to 151 days. Follow up period ranged from four to 24 months. Conclusion: Improvisation of synthetic cast for external fixator clamp is effective in acute management of open extremity fractures as well as during subsequent care.

improvisation, external fixation, clamps, open fractures, management