External fixator in the treatment of open fractures of tibia

ABSTRACT

To evaluate the outcome of external fixator used as a definitive mean of fixation in open fracture of tibia. This cross sectional study conducted at Orthopaedics Unit District Headquarter Hospital Timergara from December 2005 to September 2008 included 40 patients with grade II, grade IIIA and IIIB open fractures of tibia. Patients with grade I, grade IIIC open fractures and the patients who needed amputation for their injuries were excluded from the study. Patients with insufficient follow up were also excluded. In all these patients an aggressive approach of early initiation of treatment, radical debridement and irrigation was adopted. All the fractures were stabilized with AO external fixator, and early soft tissue coverage was provided in these patients. On removal of the external fixator Sarmiento functional brace was used till the time of union in all these patients. The mean age of the sample was 28.80 +/- 9.87. The most common mechanism of injury in these 40 patients was road traffic accidents. Pin tract infection the commonest complication, noted in 10[25%] patients, deep wound infection in 4[10%] patients, delayed union in 4[10%] patients, and mal union, non union in none of them. Dynamisation of the fixator was done in 12[30%] patients and prophylactic bone grafting was performed in 4[10%] patients. The average time of fracture consolidation was 18 weeks. External fixator can be effectively used as definitive mean of fixation in open fractures of tibia with extensive soft tissue damage