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THE USE OF EXTERNAL FIXATION IN THE MANAGEMENT OF OPEN TIBIA FRACTURES. TRANSITORY OR PERMANENT METHOD?



Abstract

Objective: 57 open tibia fractures treated with external fixation during the period 1996–2001 are presented.

Material and Methods: 57 open tibia fractures concerning 52 patients (45 males, 12 females) were treated with external fixation during the period 1996–2001. Fracture classification according Gustilo included 5 type I fractures, 14 type II fractures, 18 type IIIA fractures and 20 type IIIB fractures. The following external fixation devices were used: STAR in 3 patients, EXFIRE in 9 patients, HOFFMANN in 18 patients, ORTHOFIX in 27 patients. All open wounds were left to heal at secondary intention. The devices were fully functional within 4 to 8 weeks in 37 patients depending on the type of the fracture.

Results: 39 fractures were completely healed in a mean time of 16 weeks. Nine fractures had delayed union and finally were completely healed without using alternate devices. In 8 cases there was pseudarthrosis; internal fixation with intramedullary nail was used in seven of these cases, and 2 cases were treated with grafts. One case was complicated with septic pseudarthrosis that was treated by bone transfer in a tertiary centre.

Wound healing was achieved in 45 cases. Delayed skin surgical closure was needed in 12 cases. Needle infection rate was 27%, while in 4 cases there was deep infection and needles were removed.

Conclusion: For the vast majority of open tibia fractures, external fixation can be used as a permanent way of treatment. Clinicians should set external fixation with this permanent prospective.

The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.