Planned external fixation to locked intramedullary nailing conversion for open fractures of shaft of femur and tibia

ABSTRACT

To determine the outcome of initial external fixation and then conversion to intramedullary nailing in patients having open fracture of shaft of femur or tibia. Design: Descriptive study. Place and Duration of Study Combined Military Hospital [CMH], Quetta, from July 2002 to July 2004. Subjects and Out of 59 patients with fractures of shaft of tibia and femur, 16 were selected for the study who had open fractures in Gustilio type I, II and III. They were initially managed with external fixators and later on converted to planned locked intramedullary nailing. Interlocking nailing was done on routine operation list in the third week after Ex Fix [external fixator] was removed. Record of patients was kept, and was statistically analyzed on SPSS. Out of the16 patients, 12 had fractures of femur and 4 had fractures of tibia. Male to female ratio was 71. Mean duration of external fixation was 6.22 weeks. Six patients underwent closed interlocking nailing and 10 patients with open method. Fifteen fractures [94%] united within 6 months, and one fracture had delayed union. Two patients had superficial wound infection and one patient had deep infection. Immediate external fixation followed by early closed interlocking nailing is a safe and effective treatment for open fractures of shaft of femur and tibia