External fixation of the upper extremity.

External fixation of forearm and arm fractures is an excellent treatment option, particularly in compound, comminuted fractures that result from high-energy trauma. Limb salvage and good function have been achieved in 75% of cases by applying the principles outlined. Problems with delayed bone union have been recognized and emphasize the importance of supplemental bone grafting. A number of external fixation systems are applicable to these upper limb fractures, and the authors have not found one system superior to the others. Open pin insertion is preferred, and pins (three proximal and three distal) are ideally placed near the fracture site for optimal stability.