Do additional intramedullary elastic nails improve the results of definitive treatment with external fixation of open tibia fractures? A prospective comparative study - 19/02/13

Doi : 10.1016/j.otsr.2012.12.008

C. Ertürk ^a,^⁎ , M.A. Altay ^a, A. Bilge ^a, N. Altay ^b, U.E. Işıkan ^a
^a Department of Orthopaedics and Traumatology, Harran University School of Medicine, Yenisehir, 63100 Sanliurfa, Turkey
^b Department of Anesthesiology and Reamination, Harran University School of Medicine, Yenisehir, 63100 Sanliurfa, Turkey

Corresponding author. Harran University, Faculty of Medicine, Department of Orthopaedic Surgery, 63100 Sanliurfa, Turkey. Tel.: +90 414 318 31 48; fax: +90 414 315 11 81.

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En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Tuesday 19 February 2013
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Summary

Purpose

External fixation has been associated with a high incidence of complications and poor outcomes due to the instability and difficulty in treating open tibia fractures. We use intramedullary (IM) elastic nails to supplement the external fixator. We compared the results of fractures treated by external fixation with and without IM–elastic nail.

Hypothesis

The combination of external fixation with IM–elastic nails may be used as an alternative to solve problems due to the external fixators alone in open tibia fractures.

Methods

Group 1 included prospectively 26 cases (15 males and 11 females, mean age 37.5±12.4years) treated with external fixation and IM–elastic nails, whereas group 2 consisted of 28 cases (23 males and five females, mean age 30.7±14.0years) treated with standard external fixation. Functional and bone results were made using the criteria proposed by ASAMI.

Results

The mean follow-up period was 3.96±2.0years in group 1 and 3.32±2.1years in group 2. The mean duration to external fixation and mean time to union were significantly lower in group 1 (P<0.001). In addition, bone and functional results were significantly higher in group 1 (P<0.01), however, pin track infections were lower in group 1 (P<0.01).

Conclusion

Our results showed the improvement in outcomes with IM–elastic nails: decreased duration of external fixation need and decreased bone healing delay. Therefore, this method may be a superior alternative for preventing complications related to external fixation in open tibia fractures.