J Korean Fract Soc.
2002 Jan;15(1):45-51.
Operative Treatment of Open Tibial Fracture
- Affiliations
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- 1Department of Orthopedic Surgery, College of Medicine, Chonbuk National University Hospital, Chonju, Korea. kysong@moak.chonbuk.ac.kr
- 2Institute for Medical Science, Chonbuk National University Hospital, Chonju, Korea.
Abstract
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PURPOSE: The purpose of the present study was to clarify the contributing factors, such as the method of fracture stabilization, type of internal fixation and the deep infection rate(DIR) in the treatment of open tibial fractures.
MATERIAL AND METHODS: We made a retrospective study of these 87 open tibial fractures treated with various fixation method. Patients were divided into immediate internal fixation(IIF) group, delayed internal fixation(DIF) group and external fixation(EF) groups. Fixation methods, deep infection rate related with fixation devices and time to bone union were compared and anaylzed according to the Gustilo`s classification.
RESULTS
The mean time to union in open type I, II, IIIa, IIIb, and IIIc was 5.7 months, 8.6 months, 7.1 months, 9.7 months, and 18.0 month respectively. The mean time to union in group IIF, DIF1, DIF2 and EF was 7.2 months, 8.1 months 5.5 months, and 10.7 months and 13.1 months. The mean time to union of group using a interlocking IM nailing, plate and screws, and external fixator was 6.3 month, 6.9 months, and 10.6 months.
SUMMARY: We concluded that there is an advantage of immediate internal fixation over external fixation in the prevention of infection and promotion of fracture healing in the treatment of open tibia fractures. Immediate internal fixation could be recommended for type I, II, IIIa and some cases of IIIb open tibia fracture.