Single-Stage Conversion of External Fixation into Internal Fixation for Compound Fractures in War-Wounded Patients: A Cohort Study in Iraq

Background: War-induced. Compound fractures cause considerable damage to the limbs, affecting mobility and quality of life; surgeons consider managing compound fractures to be a difficulty. Although multi-stage conversion from external to internal fixation is still common, multiple studies worldwide are promoting single-stage conversion. Objective: To assess the efficacy and safety of a single-stage conversion from external to internal fixation using the functional results of many Iraqi war wounded patients who were initially treated with external fixation. Methods: A retrospective cohort study analyzed the data of 40 war-wounded patients (39 males and 1 female) ranging in age from 18 to 50 years. All patients came with war-related complex fractures, which were stabilized and referred for external fixation. Following a single-stage conversion to internal fixation, the patients were followed up to assess the functional outcomes of this approach using Ketenjian's functional criteria. Results: A study of 40 patients (45 limbs), mostly male (97.8%), demonstrated a statistically significant link between non-union and time to convert from external to internal fixation. However, fracture type, Gustilo categorization, fixation method, and complication rates had no significant impact on Ketenjian's score results. Conclusions: The single-staged external to internal fixation conversion is regarded as a safe and reliable procedure with good overall functional outcomes; it could be performed by experienced surgeons instead of two-staged conversions, taking into account the patient's general health and the state of the local soft tissue.