Percutaneous bridge plating of extra-articular distal fibular fracture for the management of distal tibia type III open fracture

Background: The open fracture of tibia-fibula Gustilo type III-B may threaten the survival of the injured leg. The objective of the study purpose was to see the effect of early coverage following fixation of open tibial shaft fracture.Methods: This clinical trial was carried out in National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka from July 2004 to June 2006 for a period of two (2) years. Patients at age group of 18 years or above with both sexes presented with open fracture shaft of tibia-fibula Gustilo type III-B were selected as study population. The patients were surgically managed by SIGN Interlocking nail and wound coverage by muscle flap within 72 hours of injury. Bacteriological study of the wound was done in all cases. All fixation and coverage were performed within 72 hours of injury. Patients grading improved on subsequent follow up. Evaluation of results was done at every post-operative follow up.Results: A total number of 12 young patients with open fracture tibia-fibula Gustilo III-B were recruited for this study. Their age varies from 18 years to 48 years. A total number of 83.33% cases wound debridement was done within 12 hours of injury. Most of the soft tissue healed (91.67%) within 0 to 20 days. There were no cases developed limb length discrepancy angulations or rotation. Superficial infections were occurred in 1(8.33%) case but no evidence of deep infection. In this study excellent result were obtained from 9 cases (75%), good results were found in 2 cases (16.67%), fair results from 1 case (8.33%). Conclusions: In conclusion early intramedullary fixation and exposed bone coverage by muscle flap is very important for prevention of infection, minimizing bone death simultaneously enhances bone healing.

Download Full-text

Study of outcomes of metaphyseal plate fixation in extra articular lower tibia fractures in adults

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20171550 ◽

2017 ◽

Vol 3 (3) ◽

pp. 456

Author(s):

Pratik J. Vinchhi ◽

Sharvil H. Gajjar ◽

Tirth Vyas ◽

Yatin Patel

Keyword(s):

Traffic Accidents ◽

Open Fracture ◽

Road Traffic ◽

Functional Result ◽

Plate Fixation ◽

Distal Tibia ◽

Aofas Score ◽

Closed Fracture ◽

Tibia Fractures ◽

Distal Tibia Fractures

Background: The purpose of the present study was to see results of metaphyseal plate fixation in fractures of distal tibia in adults.Methods: This is a retrospective study of 45 patients with 45 open fractures of tibia operated primarily by either Solid Titanium or Stainless steel tibia interlocking nail within 24 hours of injury.Results: In Our Study we had studied 30 lower tibial fractures treated by precontoured metaphyseal anatomical plate. 24 (80%) patients were male. 19 patients were 20-45 years age group. Mean age was 34 years. 24(80%) fractures were due to Road traffic accidents. We had 26 (86%) patients with closed fracture and 4(14%) patients with open fracture. Average time of surgery in our series was 52 minutes. 6(20%) patients had infection. And 2(6.67%) patients had nonunion and both were due to infection and required implant removal and conversion to external fixation. Average time for fracture union was 18 months. In our study of 30 patients 23(76.67%) patients had good to excellent results as assessed by AOFAS score. Conclusions: From this study we can conclude that when properly indicated the use of anatomically precontoured medial tibial metaphyseal plate in treatment of distal tibia fractures gives good union and good functional result.

Download Full-text