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Results of open tibial fracture treatment using external fixation.

Introduction
Open lower leg fractures are the most common open fractures of the locomotor system
and their treatment is associated with a number of complications.


Objective
The aim of the paper was to present the results of the treatment of 68 patients with open lower
leg fractures, as well as the complications that accompany the treatment of these fractures.


Methods
In the analyzed group, there were 45 (66.18%) men and 23 (33.82%) women. The majority of
patients – 33 (48.53%) of them – were injured in motor vehicle accidents, whereas 24 (35.29%) patients
sustained injuries due to falls from heights. In two (2.94%) patients the cause of open tibial fractures
was gunshot injuries. In the analyzed group, there were 18 (26.47%) type I open fractures, 21 (30.88%)
type II open fractures, 19 (27.94%) type IIIA open fractures, seven (10.29%) type IIIB open fractures, and
three (4.41%) type IIIC open fractures.


Results
The tibial shaft fracture healed without serious complications in 50 (73.53%) patients, whereas
in 18 (26.47%) patients we observed some complications. Nonunion was found in 10 (14.71%) patients,
osteitis in four (5.88), malunion in two (2.94%) patients. Milder complications such as soft tissue pin
tract infection developed in 13 (19.12%) patients, infection of the open fracture wound soft tissue was
observed in four (5.88%) patients.


Conclusion
Basic principles in the treatment of open lower leg fractures in this study are thorough primary
open fracture wound treatment followed by the delayed wound closure, stable fracture fixation
using unilateral external skeletal device, proper antibiotic treatment and tetanus prophylaxis. The results
correlate with similar studies.