Srpski Arhiv za Celokupno Lekarstvo (Jan 2016)
Results of open tibial fracture treatment using external fixation
Abstract
Introduction. Open lower leg fractures are the most common open fractures of the locomotor system and their treatment is associated with a number of complications. Objective. The aim of the paper was to present the results of the treatment of 68 patients with open lower leg fractures, as well as the complications that accompany the treatment of these fractures. Methods. In the analyzed group, there were 45 (66.18%) men and 23 (33.82%) women. The majority of patients - 33 (48.53%) of them - were injured in motor vehicle accidents, whereas 24 (35.29%) patients sustained injuries due to falls from heights. In two (2.94%) patients the cause of open tibial fractures was gunshot injuries. In the analyzed group, there were 18 (26.47%) type I open fractures, 21 (30.88%) type II open fractures, 19 (27.94%) type IIIA open fractures, seven (10.29%) type IIIB open fractures, and three (4.41%) type IIIC open fractures. Results. The tibial shaft fracture healed without serious complications in 50 (73.53%) patients, whereas in 18 (26.47%) patients we observed some complications. Nonunion was found in 10 (14.71%) patients, osteitis in four (5.88), malunion in two (2.94%) patients. Milder complications such as soft tissue pin tract infection developed in 13 (19.12%) patients, infection of the open fracture wound soft tissue was observed in four (5.88%) patients. Conclusion. Basic principles in the treatment of open lower leg fractures in this study are thorough primary open fracture wound treatment followed by the delayed wound closure, stable fracture fixation using unilateral external skeletal device, proper antibiotic treatment and tetanus prophylaxis. The results correlate with similar studies. [Projekat Ministarstva nauke Republike Srbije, br. III 41017: Virtual Human Osteoarticular System and its Application in Preclinical and Clinical Practice]
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