EXTERNAL FIXATOR;

Introduction: Open Tibial shaft fractures are one of the most common fractures of long bones. External fixation is methodof choice for the treatment of open tibial shaft fractures. The subcutaneous location of tibia makes it suitable for the application of externalfixator. Patients and Methods: This study was done on 50 patients at Orthopaedics and Trauma unit “B” at Khyber Teaching Hospital,Peshawar, from Jan 2008 to Feb. 2009 to determine functional outcome of A.O. external fixator in open tibial fractures in terms of knee andankle mobility, pain and gait on full body weight bearing. The data of all patients was entered in standardized proforma and analyzed onSPSS 10. Results: There were 43 (86%) males and 7 (14%) females. There were 17 (34%) type-II and 20 (40%) type IIIA and 13 (26%)type III B fractures. Knee mobility was full (100%) in 49 (98%) cases, 75% in 1(2%). 43 (86%) cases retained 100% ankle joint mobilitywhile it was 75% in 4 (8%), 50 % in 2 (4%) cases and 25 % in 1(2%) cases. On full body weight bearing, 42(84%) patients were pain free,and moderate pain was in 4(8%) cases. In 42(84%) cases the gait was completely normal on full body weight bearing while 3(6%) casesshowed significant limping. Conclusion: The excellent functional results in our series show that external fixation of tibia is safe andeffective in terms of restoring functions of tibia.

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External skeletal fixation of the tibial shaft fractures

Vojnosanitetski pregled ◽

10.2298/vsp0501011m ◽

2005 ◽

Vol 62 (1) ◽

pp. 11-15 ◽

Cited By ~ 2

Author(s):

Sasa Milenkovic ◽

Milorad Mitkovic ◽

Mile Radenkovic

Keyword(s):

External Fixation ◽

External Fixator ◽

Weight Bearing ◽

Early Mobilization ◽

Tibial Shaft ◽

Closed Fracture ◽

Early Weight Bearing ◽

Shaft Fractures ◽

Pin Tract Infection ◽

Tibial Shaft Fractures

Aim. To present the possibility of a successful use of external skeletal fixation in treating the open and closed tibial shaft fractures with Mitkovic?s external fixator. Methods. External fixation was used in 115 patients with 118 fresh tibial shaft fractures, 82 males (71.3%) and 33 females (28.7%), average age 43.92 years (16?84). Open tibial shaft fractures were present in 37 (31.36%). All the fractures were treated with Mitkovic?s external fixator type M 20. Results. The results of external fixation were excellent or good in 94.07% of the cases, and bad in 5.08%. Pin tract infection appeared in 7 (5.93%) patients. In only 3 cases an external fixator was removed and treatment continued with the functional braces. Nonunion occurred in 6 (5.08%) patients, of which 4 were with open fractures (2 Gustilo type IIIB, 1 Gustilo type IIIA, 1 Gustilo type II) and 2 with the segment fractures. Compartment syndrome was observed in 1 (0.85%) patient with closed fracture. Malunion was found in 2 (1.69%) patients. Conclusion. External fixation of tibial shaft fractures is a simple and effective method to enable the safe healing of fractures, early mobilization of the patients, early weight-bearing, as well as early rehabilitation. Fixation of tibial shaft fractures was unilateral with convergent pins orientation, and there was also a possibility of compression and distraction.

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OPEN TIBIAL SHAFT FRACTURES

The Professional Medical Journal ◽

10.29309/tpmj/2014.21.04.2298 ◽

2018 ◽

Vol 21 (04) ◽

pp. 654-658

Author(s):

Muhammad Imran Khan ◽

Muhammad Saqib ◽

Waqar Alam

Keyword(s):

Tract Infection ◽

External Fixation ◽

External Fixator ◽

Clinical Results ◽

Late Complications ◽

Tibial Shaft ◽

Union Rate ◽

Shaft Fractures ◽

Tibia Fractures ◽

Tibial Shaft Fractures

Objective: The purpose of the study was to evaluate the clinical results afteroperative treatment of open tibia fractures (grade IIIA/B) with external fixator. Material andmethods: 25 patients with open fractures of the tibial diaphysis, classified as type III A and B,according to the Gustilo classification, were operatively treated in Agency Headquarter HospitalLandikotal. All the patients were treated with an external fixator. The time of the union of thefracture, problems with the union (malunion and nonunion), infection were examined astreatment outcome. Late complications and their treatment was not the object of the study. Thefollow-up period was at least 8 months. Result: The end results of the external fixation of 25 tibialshaft fractures, 18 (72%) men and 7 (28%) women, average age 37.7 (16-65). The union rate was83%. Nonunion rate was 12%. And malunion rate was 5% (fig-I). Fifteen patients had Gustilo typeIIIA injury while 10 patients had type IIIB injury (fig-II). Pins tract infection rate was 10%. Theaverage time of fractures healing was 28.5 weeks (15-22). There were 3 cases with woundinfection and no sequestrum formation. Conclusions: External fixation is a simple and effectivemeans of treating all types of open tibial shaft fractures

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Treatment of tibial shaft fractures with Mitkovic type external fixation: Analysis of 100 patients

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh161206137b ◽

2017 ◽

Vol 145 (11-12) ◽

pp. 605-610

Author(s):

Aleksandar Bozovic ◽

Rade Grbic ◽

Dragisa Milovic ◽

Zlatan Elek ◽

Dusan Petrovic ◽

...

Keyword(s):

External Fixation ◽

Functional Results ◽

Healing Time ◽

Type I ◽

Tibial Shaft ◽

Adult Males ◽

Results Of Treatment ◽

Shaft Fractures ◽

Pin Site ◽

Tibial Shaft Fractures

Introduction/Objective. Tibial shaft fractures (TSF) are one of the most common fractures. External fixation (EF) may be used to treat TSF. The aim of this study was to analyze the treatment of TSF with Mitkovic EF. Methods. The study included 100 patients with TSF treated with Mitkovic EF as the primary and definite method of treatment. The results are compared to those in the literature. Results. The patient group comprised 67% male and 33% female patients aged 10?71years. TSF is common in adult males in the fourth and fifth decades of life. The most common cause is falling with the twisting of the leg (59%). Closed fractures were observed in 76 patients (57.4% of type A AO, 25.4% of type B AO, and 17.1% of type C AO), and open fractures in 34 patients (50% of type I GA, 32.35% of type II GA, and 17.64% of type III GA). The average time period from injury to surgery was 2.5 days (the range being 4 hours to 9 days). Bone healing was achieved in 93% of patients. The average healing time was 18.4 weeks (the range being 11?32 weeks). The distribution of complications is as follows: 10% for minor pin site infections; 4% for major pin site infections; 6% for nonunion; 1% for acute respiratory distress syndrome; 2% for osteitis. There was no deep vein thrombosis nor neurovascular damage. EuroQol score was excellent in 82% of the patients. Conclusion. Mitkovic EF can be used for treating all types of TSF. Functional results of treatment by this method are excellent. The data analysis of the series does not differ from the data in the literature.

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Comparative studies on intramedullary nailing versus ao external fixation in the management of gustilo type II, IIIA, and IIIB tibial shaft fractures

Saudi Journal of Sports Medicine ◽

10.4103/1319-6308.164303 ◽

2015 ◽

Vol 15 (3) ◽

pp. 262

Author(s):

Arunima Chaudhuri ◽

Soma Datta ◽

PradipKumar Ghosh ◽

DhirajGirish Patil ◽

Soudip Sinha ◽

...

Keyword(s):

External Fixation ◽

Intramedullary Nailing ◽

Comparative Studies ◽

Type Ii ◽

Tibial Shaft ◽

Shaft Fractures ◽

Tibial Shaft Fractures

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Paediatric tibial shaft fractures treated by open reduction and stabilization with monolateral external fixation

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.12.170056 ◽

2018 ◽

Vol 12 (1) ◽

pp. 20-28 ◽

Cited By ~ 2

Author(s):

A.-L. Simon ◽

N. Apostolou ◽

C. Vidal ◽

E. Ferrero ◽

K. Mazda ◽

...

Keyword(s):

Surgical Treatment ◽

External Fixation ◽

Weight Bearing ◽

Full Weight Bearing ◽

Lateral Side ◽

Tibial Shaft ◽

Shaft Fractures ◽

Surgical Data ◽

Mean Time ◽

Tibial Shaft Fractures

Purpose Elastic stable intramedullary nailing is increasingly used for surgical treatment of tibial shaft fractures, but frequently requires immobilization and delayed full weight-bearing. Therefore, external fixation remains interesting. The aim was to report clinico-radiological outcomes of monolateral external fixation for displaced and unstable tibial shaft fractures in children. Methods All tibial fractures consecutively treated by monolateral external fixation between 2008 and 2013 were followed. Inclusion criteria included skeletal immaturity and closed and open Gustilo I fractures caused by a direct impact. Patients were seen until two years postoperatively. Demographics, mechanism of injury, surgical data and complications were recorded. Anteroposterior and lateral side radiographs were performed at each visit. Full-limb 3D reconstructions using biplanar stereroradiography was performed for final limb length and alignment measures. Results A total of 45 patients (mean age 9.7 years ± 0.5) were included. In all, 17 were Gustilo I fractures, with no difference between open and closed fractures for any data. Mean time to full weight bearing was 18.2 days ± 0.7. After 15 days, 39 patients returned to school. Hardware removal (mean time to union 15.6 weeks ± 0.8) was performed during consultation under analgesic gas. There were no cases of nonunion. No fracture healed with > 10° of angulation (mean 5.1° ± 0.4°). Leg-length discrepancy > 10 mm was found for six patients. Conclusions This procedure can be a safe and simple surgical treatment for children with tibial shaft fractures. Few complications and early return to school were reported, with the limitations of non-comparative study. Level of Evidence: IV

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Comparative study on intramedullary nailing versus AO external fixation in the management of gustilo type II, IIIA, and IIIB tibial shaft fractures.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.06.4096 ◽

2020 ◽

Vol 27 (06) ◽

pp. 1199-1205

Author(s):

Khawand Bukhsh Umrani ◽

Zamir Hussain Tunio ◽

Mohammad Aslam Mengal ◽

Abdul Hafeez Qureshi ◽

Parvez Ahmed ◽

...

Keyword(s):

Comparative Study ◽

External Fixation ◽

External Fixator ◽

Type Ii ◽

Tibial Shaft ◽

Interlocking Nail ◽

Type Iiia ◽

Type Iiib ◽

Diaphyseal Fractures ◽

Tibial Shaft Fractures

Objectives: To compare the external fixator and unreamed interlocking nail in treating Gustilo type II, type IIIA, and type IIIB tibial diaphyseal fractures regarding complications. Study Design: Cross-Sectional and Comparative Study. Setting: Department of Orthopaedic Surgery and Traumatology (DOST) Liaquat University of Medical and Health Sciences Jamshoro/Hyderabad. Period: Two years February 2016 to January 2018. Material & Methods: 40 cases of open tibia fractures in Patients of Gustilo type II, type IIIA, and type IIIB tibial diaphyseal fractures were included. The data were analyzed using the statistical program SPSS version 16.0. Results: A total of 23 cases were treated by external fixator and 22 cases were treated by unreamed solid interlocking nail. A total of 14 cases, that is, 31% showed delayed union. Type II injury 3/15 = 20%; Type IIIA injury 6/22 = 27.3%; Type IIIB injury it is -5/8 = 12.5%. For cases treated with unreamed nail, it was 22.7%; external fixator was 39.1% among 45 cases, 05 cases showed nonunion. For cases treated with unreamed nail, it was 13.6%; external fixation was 8.7%. The overall rate of eep infection is 11.1%. The rate in interlocking nail was 13.6%, and external fixation was 8.7%. Reoperation in the form of dynamization and bone graft application after 20 weeks in unreamed nail was 36.4%, whereas in external fixation the rate was high, almost 48%. The average time of union with unreamed interlocking was about 25.4 weeks, wherein external fixation it was 28.6 weeks. Conclusion: External fixators are a good and reliable method of stabilization of Gustilo type II, type IIIA, and type IIIB tibial diaphyseal fractures, unreamed interlocking intramedullary nail yields better results in treating Gustilo type II and type IIIA tibial shaft fractures.

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Management of high-energy tibial shaft fractures using the hexapod circular external fixator

BMC Surgery ◽

10.1186/s12893-021-01106-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yanshi Liu ◽

Jialin Liu ◽

Maimaiaili Yushan ◽

Zhenhui Liu ◽

Tao Zhang ◽

...

Keyword(s):

Clinical Outcomes ◽

External Fixator ◽

High Energy ◽

Bone Union ◽

Tibial Shaft Fracture ◽

Tibial Shaft ◽

Clinical Visit ◽

Shaft Fractures ◽

Definitive Management ◽

Tibial Shaft Fractures

Abstract Background The hexapod external fixator (HEF) is increasingly used for high-energy tibial shaft fracture care as more general orthopedic surgeons are gaining expertise of this versatile device. The purpose of this study was to evaluate the clinical effectiveness of the HEF for definitive management in patients with high-energy tibial shaft fractures. Methods The study was conducted on 34 patients with tibial shaft fractures who were admitted or referred to our institution and consented to HEF treatment from Jan 2016 to June 2019, including 27 males and 7 females with a mean age of 39 years (range 18 to 65 years). Patients' clinical and radiological data, and the final clinical outcomes at a minimum of 12 months follow-up were collected and retrospectively analyzed. All complications were documented according to Paley’s classification. The clinical outcomes were evaluated using the Association for the Study and Application of the Method of Ilizarov criteria (ASAMI) at the last clinical visit. Results All patients remained in the HEF for a mean of 26 weeks (range 15 to 52 weeks) and acquired complete bone union. The satisfactory alignment was achieved in all patients, and all the patients were able to perform daily activities with no difficulty at the last clinical visit. Complications included pin tract infection (44%), delayed union (6%), nonunion (3%), and joint stiffness (3%). The ASAMI bony result was excellent in 31 patients and good in 3. The ASAMI functional result was excellent in 27 patients, good in 6, and fair in 1. Conclusions Definitive management using the hexapod external fixator is an alternative and effective method for high-energy tibial shaft fractures, including technical advantages of early trauma-control, the versatility of achieving excellent alignment, and the continuity of device until bone union.

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