Abstract
Purpose of the study:
Is circular external fixation a safe and effective method of managing closed distal third tibia fractures. These fractures are conventionally treated with plaster casts, intramedullary nails or plate fixation. These treatment modalities have complication rates in the literature of up to 16% malunion, 12% non-union, and 17% deep infections.
Description and Methods:
Retrospective review of 18 patients with closed distal third tibia fractures, with or without extension into the ankle joint, treated with circular fixator systems and minimal percutaneous internal fixation of the intra-articular fragment if required. Patients were followed up for time to union, malunion incidence as well as incidence of pin tract and deep infection. Distal third fractures which were extra articular or with simple intra articular extension were included. (AO 43 A, B1, C1, C2 + AO 42 in distal third) Patients with pilon fractures (AO 43 B2, B3 and C3) were excluded.
Summary of results:
The average time to union in these patients was 16 weeks (11–33 weeks). The non-union rate was 11.1% in comparison to 12% with conventional treatment. The malunion rate was 0% compared to 16% with conventional treatment. The incidence of pin tract infection was 16.6%, but no deep infections were noted, whilst conventional treatment shows deep infection in up to 17%.
Conclusion:
Circular external fixation is a safe and efficient option in the treatment of distal tibia fractures. The incidence of complications is significantly reduced in comparison to conventional treatment.
