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Sequential intramedullary nailing of open tibial shaft fractures after external fixation

Siebenrock, K. ; Gerich, T. ; Jakob, R.

In: Archives of Orthopaedic and Trauma Surgery, 1997, vol. 116, no. 1-2, p. 32-36

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    Titre
    • Sequential intramedullary nailing of open tibial shaft fractures after external fixation
    Auteur
    • Siebenrock, K.. Department of Orthopaedic Surgery, Inselspital, University of Bern, CH-3010, Bern, Switzerland
    • Gerich, T.. Unfallchirurgische Klinik der Medizinischen Hochschule, Hannover, Germany
    • Jakob, R.. Department of Orthopaedic Surgery, Inselspital, University of Bern, CH-3010, Bern, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Archives of Orthopaedic and Trauma Surgery, 1997, vol. 116, no. 1-2, p. 32-36. Springer-Verlag
    Autre version électronique
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:310121
    Summary
    Abstracts: We reviewed 32 tibial shaft fractures in 31 patients treated with sequential intramedullary nailing after primary external fixation. There were 30 open fractures and 2 closed injuries with severe blunt trauma requiring fasciotomy. Fifty per cent of the fractures were classified as Gustilo type III A and B injuries [13]. The mean external fixation treatment averaged 6.6 weeks, and secondary intramedullary nailing was done on average 7.4 weeks after injury. In 50% of the fractures, secondary nailing was done at the same procedure as removal of the external fixation. Overall, the incidence of osteomyelitis and nonunion was 3.1% each and of malunion 19%. The time to full weight-bearing averaged 31.2 weeks. The results were separately analyzed according to Gustilo types and subtypes. In the Gustilo type III B injuries, the incidence of osteomyelitis and non-union was 11 %, while malunion occurred in 33%. The time to full weight-bearing averaged 53 weeks. These results support the conclusion that this treatment modality is a valid alternative to other treatment options. However, previous pintract infections should be regarded as a contraindication for secondary nailing