Title: Management of open Fractures of both Bones of Leg Treated by Internal Fixation of Fibula and External Fixation of Tibia
Authors: Dr Iqbal Singh Ghai (MS), Dr Manpreet Singh, Dr Partap Singh M.S
DOI: https://dx.doi.org/10.18535/jmscr/v6i4.26
Abstract
A prospective study of open fractures of both bones of leg in 25 patients managed and stabilized with Internal Fixation of Fibula and External Fixation of Tibia was undertaken at the Department of Orthopaedics, Govt. Medical College, Amritsar from July 2015 - July 2017. Inclusion criteria of study were open grade II, IIIA and IIIB fractures according to modified Gustilo-Anderson classification. Common mode of injury was road traffic accidents in 20 (80%). Age ranged between 5 - 75 years, average 38.2 years. Males were 21 (84%) and 4(16%) females. Split thickness skin graft (12 (48%) out of 25 cases) and rotational fasciocutaneous flap (3 (12%) out of 25 cases) was given to cover the exposed bone. 21 fractures out of 25 united. Average time to union was 19.87 weeks (range, 12-28 weeks). Major complications were pin tract infection in 04 (16%) patients, delayed union in 02 (8%) and non-union in 03 (12%) patients.
Keywords: Open Fractures, Management, Internal Fixation, External Fixator.
References
- Andrew N. Pollak, M.D. Melissa L. McCarthy, SC.D., O.T.R. Andrew R. Burgess, M.D. and the lower extremity assessment project (LEAP) study groups. Short – term wound complications after application of flaps for coverage of traumatic soft tissue defects about the tibia. JBJS volume 82-A, No. 12 December 2000.
- Syed Muhammad Awais, Naseer Mahmood Akhtar. Management of segmental defects by intercalary bone transport using Naseer – Awais Fixator. Journal of Pakistan Orthopaedic Associ-ation, volume 2, No. 5, August 1992.
- Gustilo, Burgess, Tscherne, AO/ASIF group & others. Campbell’s operative Orthopaedics, edited by S. Terry Canale, 9th edition, Volume- 3, Chapter 46, General principles of fracture treatment, Page no. 2025.
- Gustilo, R.B & Mendoza, R.M. Results of treatment of 1400 open fractures. In Gustilo R, B (ed.) Management of open fractures & their complications, PP, 202- 208, Philadelphia W.B. Suanders 1982.
- Gustilo, R.B. and Anderson, J.T. 1976. Prevention of infection in the treatment of open fractures of long bones. Journal of bone & joint surgery, 58A, 453 – 458.
- Irwin-A open fractures of tibia in children, injury Vol. 26, 1995: page 21.
- Levy, A.S., Bromberg, J., & Jasper, D. Tibial fractures produced from the impact of a baseball bat. J. Orthop. Trauma 8:154-158, 1994.
- Muller et al. 1991. Muller-ME; Allogwer M; Schiender. R et al. Manual of Internal Fixation by AO/ASIF group. Heidel-berg, Springer-Verlag.
- Muhammad Aslam Ghaloo, Evaluation of role of external fixator in the management of open fractures. Journal of Pakistan Orthopaedic Association. Volume 9, No. 14, February 1997.
- Putnam MD; Walsh- TM. External fixation for open fractures of the upper extremity. Hand. Clin. 1993. Nov. (4): 613- 23.
- Romnen PM. & bross – PL. The significance of soft tissue trauma for fractures healing. Acta- Chir - Belg.1992.95 (3): 133 - 41.
- Gopal, S. Majumder, A. G. B. Batchelor, S. L. Knight, P. De Boer, R. M Smith. Fix and flap: the radical Orthopaedic and plastic treatment of severe open fractures of the tibia. J. Bone and joint surgery, volume 82-B, No. 7, September 2000.
- K. Moda; G.S. Kalra; R.S. Gupta; N.K. Maggu; R.K. Gupta; M.K. Kalra. The role of early flap coverage in the management of fractures of both bones of leg. Injury. 1994, 25:2, 83-86.
- Thakur – AJ; Patnakar. J. Open tibial fractures. Treatment by uniplanar external fixation and early bone grafting. J – Bone – Joint – Surg. Br. 1991 May. 73 (3) 448 – 57.