Use of the Kalnberz external fixator on comminuted open fractures of the upper tibia caused by war injuries

Gunshot wounds of the tibia with considerable overlying skin loss frequently need flap cover; external fixation possibly bone grafting. Treatment of such injuries requires time. Rigid fixation of bone can be achieved by the use of an external fixator. If fractures are located in the upper third of the tibia only a few types of the external fixator will not compromise joint function. One such fixator is the Kalnberz apparatus. The Kalnberz fixator is a simplified version of the Ilizarov fixator. Its use involves a cruciform introduction of two pins in the plane. External fixation was first suggested by R Wittimoser (1949); but it was C A Ilizarov who began to develop the method in 1954

The use of cutaneous turnover flaps to replace skin loss in the leg

Soft tissue loss is a frequent accompaniment to open fractures of the tibia and chronic osteomyelitis associated with pseudarthrosis. In Mozambique most of these problems follow war injuries. There are many methods of closing these soft tissue defects; but the best way is the use of a flap. This paper describes the use of a one stage de-epithelialised cutaneous turnover flap in three patients. It is applicable to many circumstances and is quick and easy to perform