Treatment of type IIIA open fractures of tibial shaft with Ilizarov external fixator versus unreamed tibial nailing

İnan, Muharrem; Halıcı, Mehmet; Ayan, İrfan; Tuncel, Mehmet; Karaoğlu, Sinan

doi:10.1007/s00402-007-0332-9

Cited by 85 publications

(108 citation statements)

References 26 publications

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“…However, regarding soft tissue injury and delayed healing, there was no significant difference between both methods [15,16]. These results are in line with previous meta-analysis and studies conducted by Bhandari et al [9] and Inan et al [17]. BOA/BAPRAS guidelines indicate that in the situation where skeletal stabilization is achieved using internal fixation, definitive soft tissue cover must be achieved at the same surgical procedure [2].…”

Section: Comparison Of Different Types Of Fixationsupporting

confidence: 78%

“…This therefore prevents further injury to the soft tissue envelope and preserves blood supply. It also has a positive effect on control of pain and limb oedema by improving perfusion and venous return of the affected limb [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. The BOA/BAPRAS guidelines advocates the use of the spanning external fixator, however care needs to be taken on applying the external fixator as access to the wounds by the plastic surgeons is required for soft tissue reconstruction.…”

Section: Rigid Stabilizationmentioning

confidence: 99%

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Current Concepts and Principles in Open Tibial Fractures - Part II Management

Poletti¹

2017

MOJOR

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Throughout history, there has been a fear of open tibial fractures due to the high incidence of infection potentially leading to amputation and death. Before the development of standardized surgical wound treatment and antisepsis, amputations were frequently required to prevent spread of sepsis and risk of death. Even today, this remains a challenging condition to treat. In recent years efforts have been made to develop new techniques and to promote new evidence based guidelines for the management of these injuries. The cooperation between orthopaedic and plastic surgeons together with the use of modern surgical instruments and techniques and modern wound management has resulted in a dramatic reduction in infection rates in many parts of the developed and developing world.

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Section: Comparison Of Different Types Of Fixationsupporting

confidence: 78%

Section: Rigid Stabilizationmentioning

confidence: 99%

Current Concepts and Principles in Open Tibial Fractures - Part II Management

Poletti¹

2017

MOJOR

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“…14 The recent increase in the use of circular external fixators for open tibial fractures is encouraging especially in high energy injuries but this method has to be individualised on a patient-to-patient basis. 15,16 The efficacy of intramedullary nails in the acute management of open tibial fractures is contentious. 17,18 The fear of osteomyelitis has previously precluded any form of internal fixation especially in the immune-compromised host and delays in operative management greater than six hours.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of intramedullary nailing for open fractures of the tibial shaft

Seron¹,

Rasool

2018

SA orthop. j.

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Aim: To establish superficial and deep infection rates and time to union of open tibial shaft fractures treated with primary debridement and locked intramedullary nails. Materials and methods:The clinical records and radiographs were retrospectively reviewed of 74 Gustilo-Anderson grades 1 to 3A open tibial shaft fractures that were treated by initial debridement and intramedullary nail fixation over a two-year period. Sixty-three men and nine women with a mean age of 33 years (range 16-67) were followed up for a mean period of 18 months (range 7-32).Results: Sixteen patients (22%) sustained grade 1 injuries, 38 (51%) grade 2, and 20 (27%) had grade 3A injuries. Thirteen patients (18.1%) were HIV positive. The mean time to surgery was 28 hours (range 8-112). The overall infection rate was 17.6%. Superficial infection developed in 10.8% and deep infection occurred in 6.8%. There was no association between time to surgery and infection rate (p=0.878). There was no association between HIV status and infection (p=0.471). There was no association between type of closure and sepsis (p=0.410). The mean time to union was 17 weeks (range 12-50). Five patients (6.9%) had delayed union and one patient failed to unite without undergoing secondary procedures. Conclusion:The management of Gustilo-Anderson grade 1 to 3A open tibial shaft fractures with primary debridement and locked intramedullary nailing shows good short-term results with low infection and non-union rates despite delay in surgical management or HIV infection. Level of evidence: Level 4Key words: open tibial fractures, intramedullary nails, infection, union

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“…In our study 4 patients had fair results due to knee and ankle stiffness. Incidence of Refracture in the consolidate is a troublesome complication but seen in rare case [35] . These fractures usually arise due to early frame removal.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2017

Int. J. Orthop. Sci.

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Introduction: Tibia shaft fractures can be treated with various modes, each having its merits and demerits. The aim of our study was to analyze clinical outcome of Ilizarov technique in patients with tibia shaft fracture. Method: 50 patients with isolated tibia shaft fracture treated with Ilizarov external fixator were followed prospectively for one year. Depending upon the level of fracture 4 or 5 rings were used. Weight bearing as per patient pain tolerance was allowed within 24 to 48 hours. The decision of frame removal was taken based on Ramos criteria. The function was evaluated based on Johner and Wruh's criteria. Results: According to Johner and Wruh's criteria, 34 patients had excellent, 12 patients had good and 4 patients had fair results. No poor results were noted. There was no case of re-operation and re-fracture. Pin-site infections were seen in 14% cases but there were no deep infections. Conclusion: Ilizarov technique can be used as an early definitive management in tibia shaft fractures with excellent clinical outcome.

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Treatment of type IIIA open fractures of tibial shaft with Ilizarov external fixator versus unreamed tibial nailing

Cited by 85 publications

References 26 publications

Current Concepts and Principles in Open Tibial Fractures - Part II Management

Current Concepts and Principles in Open Tibial Fractures - Part II Management

Outcomes of intramedullary nailing for open fractures of the tibial shaft

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