Eighteen children with dislocated fractures of the tower extremities were operated on with a dynamic axial unilateral external fixator, the Orthofix system. Telescopic facility allows easy conversion from rigid to dynamic fixation. Seven girls and 11 boys with an average age of 11 3/4 years were treated. The material comprised 10 femoral and nine tibial fractures (one girl had both fracture types). Average follow-up of these children was 19 months. Closed reduction was possible in 11 cases, and eight fractures were treated by open reduction. Physiotherapy for the adjacent joints was started on the second postoperative day. In 14 of the 18 patients, partial weight-bearing crutches was also started at this time. Average hospital stay was 13 days. At the first radiographic indication of periosteal callus, dynamic loading was started. Removal offered as an outpatient procedure, was performed after an average time of 9 weeks. In one case, pin-tract-infection developed, requiring deep soft tissue revision. No pin hole loosening, chronic infection, non-union, and or malalignment occurred. For all patients, we achieved an overall success rate of < 10-degrees angular deviation, < 1.5 cm leg length discrepancy and full range of associated joint movements.
