Original Articles
Vol. 15 (2020)
THE CHALLENGE OF OPEN TIBIAL SHAFT FRACTURES: WHEN TOMANAGE WITH EXTERNAL FIXATION AND WHEN TO USEINTRAMEDULLARY NAILING?
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Treatment of open tibial shaft fractures is challenging. External fixation (EF) is comparatively safe
in treating these open injuries with the main advantages of easy application, minimal additional
disruption, and convenient subsequent soft tissue repair. Tibial intramedullary nailing (IM) is
optimal for the treatment of open tibial fractures. This study aims to report the outcomes of our
multi-center experience in the management of open tibial shaft fractures, evaluating the efficacy
and safety of using either the external fixation (EF) or intramedullary nailing (IM).In this study,
clinical-radiographic results were evaluated in 26 cases of open fractures treated with an external
fixator and intramedullary locking nail for the period from January 2012 to December 2016 at
Level 1 trauma centers. Patients were evaluated for an average period of 12 months, observing the
healing of the fracture at 1 month, 3 months, 6 months and 12 months. General assessment
indicators included the direct cost of hospitalization and the times of the first surgery, full weight
bearing, and complete union. Infections and complications in union or limb alignment were
compared as primary outcomes. Additionally, the number of patients who switched fixation system
for various reasons was analyzed. The population we studied was predominantly male. The
predominant etiology was due to traffic accidents. The type of fracture exposure was mostly type I.
We mainly observed fracture healing with EF and had low complication rates. However,
hospitalization health costs were high. In view of the obtained results from this study, it is clear that
the type of treatment for open tibia diaphyseal fractures depends on the extent of the lesion and on
the surgical manual skills of the surgeon, but in general, external fixation (EF) is a good method for
preventing complications in cases of polytrauma and prevention of infection in open fractures
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THE CHALLENGE OF OPEN TIBIAL SHAFT FRACTURES: WHEN TOMANAGE WITH EXTERNAL FIXATION AND WHEN TO USEINTRAMEDULLARY NAILING? (2025). EuroMediterranean Biomedical Journal, 15. https://www.embj.org/home/article/view/138
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