Bone tissue repair in patients with open diaphyseal tibial fracture treated with biplanar external fixation or reamed locked intramedullary nailing

Bone tissue repair in patients with open diaphyseal tibial fracture treated with biplanar external fixation or reamed locked intramedullary nailing

Abstract Introduction Open tibial fractures are usually caused by high-energy trauma. There is no consensus about the best treatment for these fractures. Biomechanical studies show that fixing on two planes approaches the rigidity of the bone, whereas the use of interlocking intramedullary nailing i...

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Bibliographic Details
Published in:Injury Vol. 45; pp. S32 - S35
Main Authors: Rodrigues, Fábio Lucas, de Abreu, Luiz Carlos, Valenti, Vitor Engrácia, Valente, Andre Lage, da Costa Pereira Cestari, Rafael, Pohl, Pedro Henrique Isoldi, Rodrigues, Luciano Miller Reis
Format: Journal Article
Language:English
Published: Netherlands Elsevier Ltd 01-11-2014
Subjects:
Adult
Bone Malalignment - diagnostic imaging
Bone Malalignment - physiopathology
Bone Malalignment - surgery
Bone Nails
Diaphyses - diagnostic imaging
Diaphyses - injuries
Diaphyses - surgery
External Fixators
Female
Fracture Fixation, Intramedullary
Fracture Healing
Fractures
Fractures, Open - diagnostic imaging
Fractures, Open - physiopathology
Fractures, Open - surgery
Fractures, Ununited - diagnostic imaging
Fractures, Ununited - physiopathology
Fractures, Ununited - surgery
Humans
Intramedullary fixation of fractures
Male
Middle Aged
Orthopedics
Prospective Studies
Quality of Life
Radiography
Tibial fractures
Tibial Fractures - diagnostic imaging
Tibial Fractures - physiopathology
Tibial Fractures - surgery
Treatment Outcome
External fixators
Tibial fractures
Fractures
Intramedullary fixation of fractures
Quality of life
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Summary:Abstract Introduction Open tibial fractures are usually caused by high-energy trauma. There is no consensus about the best treatment for these fractures. Biomechanical studies show that fixing on two planes approaches the rigidity of the bone, whereas the use of interlocking intramedullary nailing is widely used and reported to produce better therapeutic results in fracture healing. Objective To compare bone tissue repair in patients with open diaphyseal tibial fracture treated with biplanar external fixation or reamed locked intramedullary nailing. Method Prospective randomised study with 68 patients undergoing two types of surgical treatment: biplanar external fixation or reamed locked intramedullary nailing. Consolidation, complications (infection, malunion and non-union) and quality of life using the SF-36 Health Survey were assessed 12 months after surgery. Results Consolidation occurred in 84.6% of patients who underwent reamed intramedullary nailing, and in 90.3% of patients who were treated with biplanar external fixation. In the intramedullary nailing group, there were two cases of non-union, three cases of malunion and two cases of infection. In the patients treated with biplanar fixation, there were three cases of non-union, five cases of malunion and no cases of infection. There were no statistically significant differences between the treatment groups for these results. Patient quality of life was statistically equal for both methods. Conclusion Treatment with biplanar external fixation was associated with statistically similar results compared with intramedullary locking.
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ISSN:0020-1383
1879-0267
DOI:10.1016/S0020-1383(14)70018-X