External Fixator As A Definitive Treatment For Tibial Diaphyseal Fractures

Background: Precarious blood supply, subcutaneous nature and lack of soft-tissue cover of the shaft of the tibia make these fractures vulnerable to open fractures with high rate of nonunion and infection. External fixators have been used to treat these open tibial fractures as temporary mode of fixation. We evaluated the role of external fixator as a definitive treatment for tibial diaphyseal fractures.

Materials & methods: 57 patients with open tibial diaphyseal fracture with various degree of soft tissues injuries, treated with external fixator as definitive fixation were included in the study. The outcome, rate of union and complications were assessed.

Results: 57 patients with mean age 34.4 (range 18 to 59 years) were included. 45 were male while 12 were females. Mean duration of trauma to surgery interval 26.5 hrs. Mean time for dynamization was 7.44 weeks. 50 patients had union with mean time of union 22.4 weeks, while 7 patients had nonunion. 13 patients had pin tract infection, out of which 7 infections healed by oral antibiotics while 6 patients eventually had pin loosening requiring change of pin under local anaesthesia. One patient had malunion.

Conclusion: External fixator is a very useful method for treatment of open tibial diaphyseal fractures which eliminates the need of second surgery and allows bone and soft tissue healing without increasing morbidity when applied properly.