Outcome Following Mini External Fixation For Open Fractures Of Proximal And Distal Metaphysis Of Tibia
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2018, Vol 4, Issue 2
Abstract
Background: Treatment of metaphyseal fractures of proximal and distal tibia in situations like open fractures, severe soft tissue swelling and skin blisters or impending compartment syndrome is challenging. Minimally invasive techniques using Mini External Fixator allows stable fixation of fracture in cancellous bone of Metaphyseal region, minimal soft tissue disruption during fixation, easy wound care, early joint mobilization and union. Aim of our study is to evaluate a simple, minimally invasive, surgeon and patient friendly, low cost, technique of Mini External Fixator for the management of metaphyseal fractures of proximal and distal tibia. Materials and Methods: 27 patients of proximal and distal metaphyseal fractures of tibia with either open fracture or closed fracture with severe soft tissue swelling and skin blisters or impending compartment syndrome were treated at our institute between February 2010 and August 2015. Inclusion criteria was proximal and distal tibial metaphyseal fractures with either open fracture or closed fracture with severe soft tissue swelling and skin blisters or impending compartment syndrome. Comminuted intraarticular and articular surface depression fractures requiring open reduction and bone grafting were excluded from the study. Percutaneous Mini External Fixator was used as primary modality of treatment in all these Patients. The functional results were assessed according to Klemm and Borner scoring system.Results: 27 patients were followed up for an averaged period of 23 months (range 6 to 33 months). 16 Patients had proximal metaphyseal fractures of tibia and 11 Patients had distal metaphyseal fractures of tibia. 15 Patients had open fractures and 12 Patients had poor skin condition due to Blebs/Abrasions/ Ecchymosis. After treatment with MEX Fixation 25 fractures united satisfactorily and the mean time to union was 13 weeks. Two Patient had non-union. In thesePatients, open wound was completely healed while the patients were in Mini External Fixator. They were treated with second stage Minimally Invasive Plate Osteosynthesis. Conclusion: Our study results demonstrated good results with MEX Fixator for proximal and distal metaphyseal fractures of tibia associated soft tissue injuries, skin blisters or impending compartment syndrome. Union and soft tissue healing, both of these are achieved in a single stage.
Authors and Affiliations
Atul A Patil, Vijay V Nemade, Ashutosh Appa Ushir, Nitin Kumar
Keywords
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