TREATMENT OF OPEN TIBIAL DIAPHYSEAL FRACTURE WITH LOCKED INTRAMEDULLARY NAILING PERFORMED LATELY

Abstract

Objectives: Paris cast, external fixator and locked intramedullary nailing each can be used in the treatment of open tibial diaphyseal fractures. Controversy rages as to latter method which is claimed to cause disturbance in the medullary blood circulation. We evaluated the results of open tibial fractures treated with locked intramedullary nailing. Material and
Methods: Twelve patients treated with intramedullary nailing were analysed, who had type I-III open tibial diaphyseal fractures according to Gustilo-Anderson. There were eleven male and one female patients, and their ages ranged from 22 to 57 years(average, 36 years). Of these 12 open tibial fractures, two were type I, five were type II, 5 were type III. Patients were followed for average 27.6 months (range: 24-47 months).
Results: The average time to bone union was 42 weeks (range: 16-88 weeks). When the bone union time was analysed according to soft tissue injury; it was 34 weeks in type I, 42.4 weeks in type II, 52 weeks in type III. There was no non-union complication. Infection developed in one case.
Conclusion: We conclude that intramedullary nailing is a good choise in the treatment open tibial diaphyseal fractures, but in type III open fractures good results depend on the amount of intramedullary reaming in cases with complex fracture and early muscle flab cover when required.