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Osteosynthesis and Trauma Care 2004; 12(4): 208-214
DOI: 10.1055/s-2004-832298
Original Article

© Georg Thieme Verlag Stuttgart · New York

Treatment of Open Tibial Fractures with External Fixation and Secondary Intramedullary Nailing by Polytraumatized Patients

D. Koulalis1 , 2 , G. Gouvas1 , G. Koulalis1
  • 1Orthopaedic Department of the General Hospital “Agios Dimitrios” Thessaloniki, Greece
  • 21st Orthopaedic Department of Hygeia Hospital, Athens, Greece
Further Information

Publication History

Publication Date:
30 November 2004 (online)

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Abstract

62 polytrauma patients with open tibial fractures were initially treated with primary external fixation followed by secondary intramedullary nailing with reaming. 28 open fractures were Gustilo Type I, 27 Type II and 7 Type III (3 III a, 3 III b,1 III c). The external fixator pin insertion sites were twice daily cleaned and disinfected. Average time between the application of the two methods was 5.2 days. The average time for initial callus appearance was 2.5 months. Superficial infection appeared in 7.1 % of Type I fractures and 7.4 % of Type II fractures. Deep infection appeared in 14.2 % of Type III fractures and non-union in 11.1 % of Type II fractures. In cases where immediate, minimally invasive stabilization is needed, secondary interlocking intramedullary nailing after initial treatment with external fixation is employed in polytrauma patients. This treatment regime provides rapid stabilization, mobilization and secures fracture healing in the treatment of open tibial fractures. It can be viewed as an alternative solution to unreamed interlocking intramedullary nailing when this is not possible.

Key words

Open tibial fractures - interlocking intramedullary nailing - external fixation - polytrauma

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Dr. D. Koulalis

Bouboulinas 12

16345 Ilioupoli, Athens

Greece

Fax: +30/10-9 95 95 59

Email: jimkoul@yahoo.com

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