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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2011, Number 1

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Acta Ortop Mex 2011; 25 (1)

Use of an external fixator in open tibial shaft fractures as definitive treatment

Patiño-Domínguez LA, Reyes-Pantoja R, Silva-Méndez JA, Vargas-Espinosa JM

Language: Spanish
References: 20
Page: 45-49
PDF size: 406.93 Kb.


ABSTRACT

Background: We conducted a study evaluating the clinical and radiologic results of the open tibial shaft fractures using an external fixator as definitive treatment. Methods: Clinical, observational, descriptive, prospective and longitudinal study. Forty-six patients were included, 40 males (87%) and 6 females (13%), whose age was 31.02 ± 14.62 years; the time elapsed from the accident to admission in the Emergency Room was 1-16 hours, with a mean of 5.1 ± 3.35 hours. Ten patients (21.74%) had a Gustilo grade I open fracture, and 36 patients (78.26%) a Gustilo grade II fracture. They were also classified according to the AO classification, with the following resulting groups: 13 (28.9%) patients were A3, 12 (26.1%) were B3, 8 (17.4%) B1, 8 (17.4%) were B2, and 5 (10.9%) were A2. The dynamization of the fixator was done at a mean of 11.56 ± 1.10 weeks. Results: Forty-three patients had healing at 23.51 ± 3.62 weeks; Gustilo I fractures healed at 22.8 ± 3.5 weeks; Gustilo II fractures at 23.7 ± 3.7 weeks, with a P value of 0.48. In 3 patients (6.53%), due to absence of healing, the external fixator was exchanged for an intramedullary nail with a bone graft, with healing occurring at 18 weeks. Six infections (13%) were reported at the nail insertion site; angulations ranged from 0° to 8°, which is tolerable. Conclusions: This fixator is safe in properly selected patients, since the few complications that occurred are similar to other reports using different internal fixation methods.


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