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The results of immediate plate fixation of 97 open fractures of the tibial shaft in 95 patients are reported. Significant joint stiffness occurred in 11.4% and angular malunion of greater than 5 degrees in any plane was seen in 3.1%. The infection rate was 10.3%. However, even in those cases which develop delayed union or other complications, plate fixation of open fractures can produce excellent recovery of limb function.

The outcomes of 97 open tibial fractures in 95 patients treated with immediate plate fixation are reported, focusing on wound healing, time to full weight-bearing (union), function, and complications, including malunion and infection. Overall, 62 wounds healed in 3 weeks or less and 26 between 3 and 6 weeks. By 30 weeks, 77 legs were fully weight-bearing and significant stiffness in one or more of the knee, ankle, or subtalar joints developed in 11.4% patients. Delayed union occurred in 32 cases (33%). Angular malunion of greater than 5° in any plane was seen in only 3.1% of patients. The deep infection rate was 10.3% overall, including 5.4% of Grade I wounds, 7.8% of Grade II wounds, and 44.4% of Grade III wounds. These rates compared well against outcomes from various other studies, indicating that plate fixation of Grade I and Grade II open fractures is a viable treatment option. However, in Grade III open fractures, due to the higher incidence of infection, plating is probably best avoided. BackgroundThis study explored the effectiveness of treating open fractures of the tibia with internal fixation using plates, a method considered controversial at the time due to concern for an increased risk of infection. External fixation and more conservative methods, such as cast immobilization, were considered the treatment of choice. However, there was some evidence at the time suggesting that the stability provided by internal fixation might actually lead to early soft tissue healing and the avoidance of infection.

Cells are used in bone tissue engineering applications to facilitate new bone formation in implants. Enzymatic digestion and marrow removal by either centrifugal force or syringe are three methods used to isolate the cells for culture, but each technique has benefits and drawbacks. This comparative study evaluated the effects of the three cell isolation techniques on the attachment, proliferation, and mineralization of rat bone cells. Cells were isolated, seeded, and cultured following standard protocols for each isolation method. Quantitative assays to determine metabolic activity, lactic acid production, glucose consumption, and amounts of intracellular protein, alkaline phosphatase activity, and extracellular calcium were performed. In addition, cell morphology and viability were examined qualitatively. The results indicate that the cell isolation method affects the attachment, proliferation, and type of tissue formed by cells cultured under identical conditions.