Complications of Dynamic Axial Fixator in the Treatment of Femur and Tibia Fractures
Vasfi KARATOSUN, Selcuk OZGEN, Ozer ULKU, Ceyhun BALCI, H Huseyin ERSOY
Keywords: Fracture, Tibia, Femur, Dynamic Axial Fixation, Complication
Purpose: The purpose of this study is, to determine the complications of Dynamic Axial Fixator (DAF) which permits dynamization during treatment period and also to make comments in order to treat and prevent such complications.
Patients and methods: One hundred-sixty nine fractures (58 femur and 111 tibia) of 165 patients were undergone evaluation mean follow-up was 39 months (not less than 12 months) and mean age of patient was 34 years (range from 8 to 80). While 23 of fractures (13 femur and 10 tibia) were closed, on the other hand 146 fractures were open-type. Open fractures were distributed according to Gustilo classification as follows; Type1 7/29, Type2 9/34, Type3A 16/19, Type3B 9/11 and Type3C 4/8, for femur and tibia, respectively. Results and Complications: Solid union time (weeks) was as follows: Closed fractures 26/24, Open fractures; Typel 25/24, Type2 26/24, Type3A 30/25, Type3B 31/28 and Type3C 30/26 in femur and tibia fractures, respectively. As major complications, malunion was 19%/11%, joint motion restriction 14%/4.5% in femur and tibia fractures. Nonunion was 1% in both groups. Pin-tract infection was encountered 18% and 26% in femur and in tibia fractures, respectively, as minor complication. In addition, mechanical failure of fixator in femur (16%) and pivotal-bending in tibia (9%) were the other minor complications.
Discussion: Finally, although DAF is a successful method in the treatment of femur and tibia fracture, possible complications has a significant rate. In order to prevent such complications, in addition to proper indications and patients' selection, experienced surgical team, a good surgical technique and close follow-up of patient are the important factors.