Open fractures of the tibia remain a formidable injury. Which the need for stabillization of open tibial fractures is accepted, the method of fracture stabilization is still controversial because of unacceptable infection rate. External
fixation
has been the routine and safe procedure for open tibia fractures. However, this is not without significant complicatios such as pin tract infection and delayed ornonunion due to insufficient stability.
We reviewed the records of 29 patients who underwent immediate unreamed locked intramedullary nailing for open tibial fractures. The average time between injury and operation was 2.4days. The classification of the open
fracture
was;
fifteen Grade I, nine Grade II, and five Grade IIIa. There was no superficial infections, but one of type IIIa patient developed deep infection. Skin graft or rotational flap to cover the scft tissue defect were performed. All cases
were
treated by primary intramedullary nailing without a change of the fixator. So, we think unreamed locked intramedullary nailing is a good alternative method for the management of Grade I, II, III a open tibisal fractures.
|