Skeletal Stabilization in the Severely Injured Limb

Reduction and stabilization of fractures in the context of the severely injured limb is an important part of the initial management. Skeletal instability puts the surrounding soft tissues at risk for further injury during transfers and nursing care. Skeletal instability even in the absence of bone loss may also compromise vascular flow by allowing limb shortening and the kinking of vessels. When the skeleton is stabilized using external or internal fixation, circumferential access to the limb can be improved for monitoring of skin, swelling, and vascular flow, as well as for surgical intervention. This paper reviews the rationale and techniques available in the management in these patient situations with particular focus on external fixation.