Dynamization of external fixator is single stage definitive procedure for open fractures both bone leg

Abstract

<p class="abstract"><strong>Background:</strong> Open fracture both bone leg is a common fracture present in orthopaedic causality. Treatment consists of I. V. antibiotics, debridement and external fixator. Judicious selection of the patients on basis of Gustilio and Anderson classification leads to external fixator as a definitive and single stage procedure with dynamization. It reduces the risk of infection at time of definitive procedure and number of hospital stay and surgery.</p><p class="abstract"><strong>Methods:</strong> In school of medical sciences and research, We treated 68 patients with open both bone fracture (Gustilio and Anderson type 2 and 3b) with debridement and external fixator. All patients underwent dynamization depending upon fracture pattern. Majority of our cases were road traffic accident involving male. Average duration of union was 22 to 26 weeks. There was no need for any major plastic surgery procedure. Removal of external fixator and Patellar tendon brace (PTB) was given for the period of 4 to 6 weeks at the time of clinical and radiological union.<strong></strong></p><p class="abstract"><strong>Results:</strong> Eighty eight percent of our cases united well. This reduces the burden of secondary definitive procedure, infection and cost of treatment. So careful selection of the patients and dynamization of external fixator hold the place for definitive surgical option for open both bone fractures.</p><p><strong>Conclusions:</strong> External fixator is simple effective surgical procedure for open fractures both bone leg. Staged dynamization of external fixator add in the better union with functional outcome and cost effective. </p>

A study on the outcome of open tibial fractures managed definitively by external fixator

“…In 1980, the study by Lawyer et al [11] in a study among 34 open tibial fractures with external fixation as a definitive management found that there was no non-union and the time for union was 23.2 weeks on average. But studies conducted by Chan et al [33] in 1984, Kesemenli et al [34] in 2004, Naique et al [35] in 2006, Beltios et al [36] in 2009, Neelakandan et al [9] in 2014, Singh et al [37] in 2017, Hao et al [38] in 2019, Parikh et al [39] in 2020 all found similar results to ours when it came to time of fracture union with external fixation as definitive management that is at 25-28 weeks. Studies by Haider et al [40] in 2019 and Hao et al [38] showed similar results to ours when it came to the rate of non-union by definitive external fixation at 16.7% and 14.1% respectively, ours is 15.2%.…”

“…Pin tract infection Chronic Osteomyelitis Golubovic et al 2016 [46] 68 14.7% 22 2.9% 19.1% 5.9% Neelakandan et al 2014 [9] 22 28 Singh et al 2017 [37] 68 22% 24 26.4% Beltios et al 2009 [36] 139 8% 25 9.4% 1.8% 26% 1.3% Kumar et al 2017 [10] 37 2.7% 21.6% 2.7% Kimmel et al 1982 [43] 15 6.6% 39 46.7% 26% 50% Tornetta et al 1994 [48] 29 28.3 14.2% 14.2% 21.4% 7.1% Kesemenli et al 2004 [34] 20 5% 28 5% Kaftandziev et al 2006 [49] 48 13.3% 38.4 16.6% 23.3% 20% Naique et al 2006 [35] 9 26 Rommens et al 1988 [47] 95 23.2% 20% 4.2% Lawyer Jr et al 1980 [11] 34 0% 23.2 Chan et al 1984 [33] 17 30% 28 60% 40% 38% Haider et al 2019 [40] 114 16.7% 2.6% Hao et al 2019 [38] 85 14.1% 27.64 40% 34.1% 42.4% 5.9% Papaioannou et al 2001 [41] 141 39.7% Parikh et al 2020 [39] 182 28 Schroder et al 1986 [42] 96 4.1% 13.5% 36% 7.2% Karlstrom et al 1975 [12] 28 31.6 Pahore et al 2010 [45] 56 8.9% 21 21.4% 3.5% 33.9% 8.9% Edwards CC et al 1988 [44] 202…”