Treatment of open tibial-shaft fractures. External fixation and secondary intramedullary nailing.

摘要: Between 1979 and 1986, sixteen of 369 open fractures the tibial shaft were treated by external fixation followed intramedullary nailing. These comprised one Type-I, two Type-II, thirteen Type-III injuries. This method treatment was original plan in nine patients (56 per cent), for delayed union while fixator still place four (25 loss reduction a plaster cast (13 osteomyelitis segmental defect patient (6 cent). The average duration 8.5 weeks; time between removal nailing, three injury twelve weeks. All until either fracture had united (eleven patients) or there an established non-union (five patients). At that time, seventeen additional procedures performed, including bone-grafting, fibulectomy, re-nailing. Only five healed without surgical major complications. progressed to all Type III, complicated deep infection. Over-all, complications included seven infections (an infection patients, two, chronic draining sinus associated with ring sequestrum one); minor during fixation, which developed into occurred after secondary nailing; eight non-unions, multiple procedures. over-all incidence 50 cent infection, 44 cent. On basis high both present series few reports literature, we concluded alternative options should be carefully considered before electing this sequential fixation.