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KMID : 0381219810130010023
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Journal of RIMSK
1981 Volume.13 No. 1 p.23 ~ p.33
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Percutaneous Pin Fixation of Open Tibial Fractures
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Abstract
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From June 1979 to June 1980, 26 severe open tibial fractures including 6 cases of postoperative infection were treated with the stable external transfixation method modified by our department.
Open tibial fractures with comminuted, segmented and extensive soft tissue damage were difficult to be reduced and maintained in alignment. Initially fractures were treated with debridement and application of the external fixaton. The wound care with daily dressing and continuous irrigation was possible. Secondary skin, flap and bone graft were part of the original plan of treatment and were easily performed. All patients were able to start the range of motion exercise in the postoperative period. The average time in the frame was 4 months and a P.T.B. cast or brace was used thereafter.
We obtained the following results.
1. The important advantages of the external fixation system were: 1) ability to care for the skin and soft tissue without worry about plaster 2) the patient could put all joints proximal and distal to the fractured bone through range of motion utilizing a special foot plate for, tibial fractures early exercise could be started in the.lower extremity to prevent a contracture of the Achilles tendon, muscle atrophy and disuse osteoporosis.
2. Excluding two patients who had amputation, the healing time was assumed to be the time between injury and the beginning of full weight bearing without external support. By these criteria the average healing time was 7.3 months.
3. The extent of damage to the skin and soft tissue was graded on a scale of I to III: we had 2 Grade I, 10 Grade II and 14 Grade III.
4. The final results after follow-ups ranging from 4 to 16 months were evaluated according to Karlstrom and Olerud scheme (1975) : the overall results were graded as excellent in 10 (38%), good in 10(38%0) and acceptable in 4 (16%).
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