scholarly journals External fixation in the treatment of open tibial shaft fractures

2008 ◽  
Vol 65 (5) ◽  
pp. 343-348 ◽  
Author(s):  
Zoran Golubovic ◽  
Predrag Stojiljkovic ◽  
Lana Macukanovic-Golubovic ◽  
Dragan Milic ◽  
Sasa Milenkovic ◽  
...  
Keyword(s):  
External Fixation ◽  
Tibial Fracture ◽  
Tibial Fractures ◽  
Open Tibial Fractures ◽  
Shaft Fractures ◽  
Tibia Shaft Fractures ◽  
The Mean ◽  
Pin Track ◽  
Tibia Shaft ◽  
Tibial Shaft Fractures

Background/Aim. Besides the conquasant fractures, open tibia shaft fractures belong to the group of the most severe fractures of tibia. Open tibia shaft fracture is one of the most common open fractures of long bones. They most frequently occur as a result of traffic accidents caused by the influence of a strong direct force. Methods. Within the period from January, 2000 to December 31, 2005. at the Clinic for Orthopaedics and Traumatology, Clinical Center Nis, 107 patients with open tibial fractures were treated. We analyzed 96 patients with open tibial fracture. In the series analyzed, the male sex was prevalent - there were 74 men (77.08%). The mean age was 47.3 years. The youngest patient was 17 years old, while the oldest patient was 79. According to the classification of the Gustilo et al. in the analysed group there were 30 (31.25%) open tibial fractures of the I degree, 31 (32.29%) of the II degree, 25 (26.05%) of the III A degree, 8 (8.33%) of the III B degree and 2 (2.08%) of the III C degree. In 95 of the patients the treatment of open tibia shaft fractures consisted of the surgical treatment of wound and the external fixation of the fractured bone using "Mitkovic" type external fixator with a convergent method of pin applications. One primary amputations had been done in patients with grade IIIC open tibial fracture with large soft tissue defect. Results. Of the 96 open tibial fractures available for follow-up, 73 (76.04%) healed without severe complications (osteitis, pseudoarthrosis, valgus malunion and amputation). Ther were nine (9.38%) soft tissue pin track infections and six (6.25%) superficial wound infections. The mean time of union was 21 (14-36) week. Among severe local complications associated with open tibial fractures, in eight patients (8.33%) was registered osteitis, and in nine patients (9.38%) fracture nonunion and the development of pseudoarthrosis. Three of the patients (3.13%) had more than 10 degree valgus malunion. In one patients (1.04%) deep pin track infection developed. Two patients (2.08%) had below the knee amputation (one primary in patient with type III C open fracture and one secondary after the development of deep infections). Conclusion. Surgical treatment of wounds, external fixation, leaving the wounds open and performing necessary debridements, adequate drug therapy administration are essential for obtaining good results in patients with open tibial shaft fractures.

Treatment of unstable closed tibial shaft fractures by external fixation

2007 ◽  
Vol 54 (2) ◽  
pp. 83-89
Author(s):  
Z.S. Golubovic ◽  
P.M. Stojiljkovic ◽  
M.B. Mitkovic ◽  
L.D. Macukanovic-Golubovic ◽  
M.Z. Bumbasirevic ◽  
...  
Keyword(s):  
Fracture Healing ◽  
External Fixation ◽  
Excellent Result ◽  
Additional Treatment ◽  
Tibial Fractures ◽  
Long Bones ◽  
Tibial Shaft ◽  
Shaft Fractures ◽  
Tibia Shaft ◽  
Tibial Shaft Fractures

The fracture of tibia shaft is one of the most common fracture of long bones. The authors bring out the results of the treatment of 90 patients with unstable closed tibial shaft fractures treated by the use of Mitkovic external fixation systems. Within the analyzed group there were 66 (73%) male and 24 (27%) female. The average patients age was 43.9 years (range 15 to 82). Excellent result in treatment of unstable closed tibial shaft fractures with external fixation were achieved in 15 (16,7%) patients, very good in 38 (42,2%) patients, good in 24 (26,7%), poor in 9 (10%) and bad in 4 (4,4%) patients. With 4 (4,4%) patients pseudoarthrosis was formed. Additional treatment of patients with pseudoarthrosis (spongioplastic and placing of CD device) led to pseudoarthrosis healing. Within the analyzed group in all patients treated with external fixation there were no registered cases of postoperative osteitis. External fixation by the use of Mitkovic external fixation is one of the method of choose in the treatment of unstable closed tibial fractures, providing dynamic and balanced biomechanical conditions for fracture healing. .

scholarly journals Application of unilateral external fixation by the “joystick technique” in the treatment of pediatric tibia shaft fractures: technical note

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xinhui Wang ◽  
Zhe Zhang ◽  
Xizhi Hou ◽  
Bao Wang ◽  
Yongdong Li ◽  
...  
Keyword(s):  
External Fixation ◽  
Clinical Outcomes ◽  
Weight Bearing ◽  
Fracture Reduction ◽  
Joint Movement ◽  
Early Recovery ◽  
Fixation Failure ◽  
Shaft Fractures ◽  
Tibia Shaft Fractures ◽  
Tibia Shaft

Abstract Background The aims of current study were to present the clinical outcomes in patients with pediatric tibia shaft fractures who were treated with unilateral external fixation combined with joystick for fracture reduction and describe the details of our technique. Methods We retrospectively analyzed the patients with pediatric tibia shaft fractures who were treated with unilateral external fixation combined with joystick for fracture reduction between July 2018 and March 2020. The clinical outcomes were evaluated. Results A total of 23 patients were included in the current study with the average age of 8.0 years (ranged 4–14 years). The average duration of hospital and follow-up were 5.9 days (ranged 4–8 days) and 17.4 months (ranged 8–27 months), respectively. At postoperative 3 days, the visual analog scale (VAS) score was 3.1 ± 1.43, which was significantly lower than the preoperative score of 7.3 ± 1.5. Of these, 2 cases showed redness and swelling of pin-tract and exudation at postoperative 1 month, who improved after oral antibiotics without causing fixation failure. The average time to full weight-bearing without crutches was 5.1 weeks (ranged 3–8 weeks). All patients achieved fracture healing and good functional recovery. No complications including fixation failure, reoperation, epiphyseal injury occurred, infection around implants, vessel damage, nerve damage, and limitation of joint movement were observed. The Johner-Wruh scores showed that 21 cases (91.3%) were “excellent” and 2 cases (8.7%) were “good.” Conclusions This procedure had advantages of simple operation, minimum trauma, early recovery of lower limb function, and no risk of complications. It may provide a new choice for children with tibia shaft fractures who require surgical treatment.

scholarly journals EVALUATION AND COMPARISON OF OPEN AND CLOSED TIBIA SHAFT FRACTURES IN A QUATERNARY REFERENCE CENTER

2018 ◽  
Vol 26 (3) ◽  
pp. 194-197 ◽  
Author(s):  
ALEX DE LIMA SANTOS ◽  
CONRADO TAZIMA NITTA ◽  
GUILHERME BONI ◽  
GUSTAVO TADEU SANCHEZ ◽  
MARCEL JUN SUGAWARA TAMAOKI ◽  
...  
Keyword(s):  
External Fixation ◽  
Readmission Rate ◽  
Traffic Accidents ◽  
Severe Trauma ◽  
Level Of Evidence ◽  
Shaft Fractures ◽  
Tibia Shaft Fractures ◽  
Prospective Comparative Study ◽  
Hospital Stays ◽  
Tibia Shaft

ABSTRACT Introduction Tibia shaft fractures are among the most common in orthopedic practice, but Brazilian literature remains limited on the subject. Objective To evaluate the characteristics of tibia shaft fractures and conduct a comparison between exposed and closed fractures of the tibia. Methods This comparative prospective study examined all tibia shaft fractures admitted to our services over a twelve-month period. The cases were evaluated according to age, trauma mechanism, sex, associated fractures, treatment, hospital stay, and readmission rate during the six months after discharge. Results Fifty-three cases met the inclusion criteria. The average age was 36 years (SD 14.3) and 83% were males (p<0.001). Traffic accidents were responsible for 73.6% of fractures (p<0.001). Exposed fractures were found in 52.8% of the cases (p=0.56). When initial treatment consisted of stabilization with external fixation, these cases were more likely to be rehospitalized (p=0.009). Cases of open fracture also had longer hospital stays (p<0.001) and a higher readmission rate (p=0.028). Conclusion Open fractures are associated with more severe trauma, expressed in longer hospital stays and high rates of readmission. Cases of fracture which were initially treated with external fixation had a higher readmission rate. Level of Evidence II; Prospective comparative study.

RETRACTED: A randomised prospective study of two different combined internal and external fixation techniques for distal tibia shaft fractures

Injury ◽  
2014 ◽  
Vol 45 (12) ◽  
pp. 1990-1995 ◽  
Author(s):  
Liao-Jun Sun ◽  
Xian-Bin Yu ◽  
Cheng-Qian Dai ◽  
Wei Hu ◽  
Xiao-Shan Guo ◽  
...  
Keyword(s):  
Prospective Study ◽  
External Fixation ◽  
Distal Tibia ◽  
Shaft Fractures ◽  
Tibia Shaft Fractures ◽  
Fixation Techniques ◽  
Tibia Shaft

Tibia Shaft Fractures Treated with the Hoffmann External Fixation

1985 ◽  
Vol 20 (3) ◽  
pp. 477
Author(s):  
Myung Chul Yoo ◽  
Dae Kyung Bae ◽  
Il Hyung Cho ◽  
Bang Sub Lee
Keyword(s):  
External Fixation ◽  
Shaft Fractures ◽  
Tibia Shaft Fractures ◽  
Tibia Shaft

scholarly journals Results of non-surgical treatment of isolated closed tibial shaft fractures

2021 ◽  
Vol 12 (4) ◽  
pp. 2303-2307
Author(s):  
Nizam Ahmed ◽  
Madan Lal ◽  
Niaz Hussain Keerio ◽  
Ghazanfar Ali Shah ◽  
Aftab Alam Khanzada ◽  
...  
Keyword(s):  
Delayed Union ◽  
Tibial Fractures ◽  
Tibial Shaft ◽  
Physical Handicap ◽  
Shaft Fractures ◽  
The Mean ◽  
Non Surgical Treatment ◽  
Tibial Shaft Fractures

This Research aimed to see how well isolated closed tibial fractures retained their reduction after being immobilized in a cast. Medical data were gathered for all patients of identified solitary closed tibial shaft fractures treated non-surgically. Males were more typically impacted than females among the 32 individuals evaluated. The mean age was 27.68 years old (SD=7.06). Direct trauma with motorcycle was the most prevalent causes of injury. The average follow-up time for each patient was 9.1 months (SD=2.36). According to the AO/OTA classification, 34.4 % of the fractures are A1.1, 28.1% are A2.1, and 37.5 % are A3. The average time for all fractures to heal was 13.7 weeks (SD=3.24). In the 22nd week, there was one occurrence of delayed union. Shortening of bone was less than 1 cm in 93.75 % of patients and more than 1.5 cm in 6.25% of patients. In 2 (6.25%) of the patients, the anterior or posterior angulation was more than 10 degrees. Furthermore, even with uncomplicated tibial fractures, there appears to be a debate about therapy selection when considering long-term physical handicap and a longer follow-up time.

scholarly journals Reamed intramedullary nailing versus circular frame external fixation for segmental tibial fractures (STIFF-F): a mixed methods feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Caroline B. Hing ◽  
Elizabeth Tutton ◽  
Toby O. Smith ◽  
Molly Glaze ◽  
Jamie R. Stokes ◽  
...  
Keyword(s):  
Mixed Methods ◽  
External Fixation ◽  
Intramedullary Nailing ◽  
Feasibility Study ◽  
Online Survey ◽  
Tibial Fracture ◽  
Tibial Fractures ◽  
Circular Frame ◽  
Pilot Rct ◽  
Randomised Controlled

Abstract Background Segmental tibial fractures are fractures in two or more areas of the tibial diaphysis resulting in a separate intercalary segment of the bone. Surgical fixation is recommended for patients with segmental tibial fractures as non-operative treatment outcomes are poor. The most common surgical interventions are intramedullary nailing (IMN) and circular frame external fixation (CFEF), but evidence about which is better is of poor quality. An adequately powered randomised controlled trial (RCT) to determine optimum treatment is required. STIFF-F aimed to assess the feasibility of a multicentre RCT comparing IMN with CFEF for segmental tibial fracture. Methods STIFF-F was a mixed-methods feasibility study comprising a pilot RCT conducted at six UK Major Trauma Centres, qualitative interviews drawing on Phenomenology and an online survey of rehabilitation. The primary outcome was recruitment rate. Patients, 16 years and over, with a segmental tibial fracture (open or closed) deemed suitable for IMN or CFEF were eligible to participate. Randomisation was stratified by site using random permuted blocks of varying sizes. Participant or assessor blinding was not possible. Interviews were undertaken with patients about their experience of injury, treatment, recovery and participation. Staff were interviewed to identify contextual factors affecting trial processes, their experience of recruitment and the treatment pathway. An online survey was developed to understand the rehabilitation context of the treatments. Results Eleven patients were screened and three recruited to the pilot RCT. Nineteen staff and four patients participated in interviews, and 11 physiotherapists responded to the survey. This study found the following: (i) segmental tibial fractures were rarer than anticipated, (ii) the complexity of the injury, study setup times and surgeon treatment preferences impeded recruitment, (iii) recovery from a segmental tibial fracture is challenging, and rehabilitation protocols are inconsistent and (iv) despite the difficulty recruiting, staff valued this research question and strived to find a way forward. Conclusion The proposed multicentre RCT comparing IMN with CFEF is not feasible. This study highlighted the difficulty of recruiting patients to an RCT of a complex rare injury over a short time period. Trial registration The study was registered with the International Standard Randomised Controlled Trials Number Registry: ISRCTN11229660

Sign in / Sign up

Export Citation Format

Share Document