Study design: Retrospective study.
Objectives: To examine the value of operative fracture stabilization by means of the ring fixator in fractures of the lower extremity in the presence of chronic paralysis caused by transverse lesions of the spinal cord.
Setting: A specialist center for the treatment of spinal cord injuries in Germany.
Methods: Clinical examination of the lower extremities with side-for-side comparison, radiological investigation of the fractures, patient survey.
Patients: In 21 patients with chronic spinal cord lesions, 22 fractures of the lower extremities were treated with the ring fixator.
Results: At follow-up a mean of 41.5 months after fracture healing it could be shown that movement in the knee and ankle joints on the same side as the fracture was not restricted by more than 10 degrees in any of our patients. No losses affecting activities of daily living were reported, and 19 of the 21 patients were satisfied with the result achieved with this technique. After four of the 22 operations there were complications. Malalignments were visible radiologically following five of the fractures.
Conclusions: In osteoporosis-induced fractures of the lower extremities in chronically paraplegic and tetraplegic patients, fracture stabilization with the ring fixator, with fewer complications and better results in terms of joint mobility, is superior to the conservative treatment so far given preference in the literature. It should be offered as an alternative to conservative treatment in the case of pathological fractures.