ABSTRACT
We report a retrospective review of all paediatric trauma patients managed with an external fixator admitted to our institution over a 7-year period. We identified 30 fractures in 28 children. The fractures included 20 tibiae, 5 femurs, 2 humerii, 2 radii and 1âphalanx. The indications were 23 open fractures, 4 comminuted fractures and 3 closed fractures in poly-traumatised patients. It was the definitive treatment in 13 fractures. The mean length of total time with an external fixator was 9.6 weeks (range 1-38 weeks.) Difficulties encountered were eight problems, one obstacle and two true complications. There were no cases of re-fracture following removal of the external fixator. This review confirms that there is a role for the use of external fixation in selected paediatric fractures with a low complication rate.
Subject(s)
External Fixators , Fracture Fixation/instrumentation , Fractures, Closed/surgery , Fractures, Comminuted/surgery , Fractures, Open/surgery , Tibial Fractures/surgery , Adolescent , Child , Child, Preschool , Female , Humans , Male , Retrospective StudiesABSTRACT
With the recent restructuring of Army infantry divisions in the new brigade combat team model, division psychiatrists are facing new and unique demands. This article outlines the varying perspectives of the position and the duties and responsibilities of a division psychiatrist. It provides guidance on how to negotiate the myriad of challenges unique to the position. Discussion includes planning and supervision, providing command consultation, educational efforts, fulfilling the roles of an officer and leader, and future directions for the position.
