Clinical study of a new design multifunction dynamic external fixator system for open tibial fracture

Abstract

Background: The tibial shaft is one of the most common sites of open fracture. External fixators emerged as the treatment of choice for high energy open tibial fractures because they were easy to apply, allow sufficient access for wound care and provide sufficient mechanical fixation for patient mobilization and bone healing. Based on the advantages of dynamization in increased union rate and the simplicity of monolateral frame, a new design dynamic external fixator system was developed for definite treatment in open tibial fracture.

Objective: To evaluate the clinical results of open tibial fractures treated with a new design dynamic external fixator system until healing.

Material and method: The case series of 60 patients with open tibial fracture treated with the new design dynamic external fixator system for acute and definitive-treatment frame between 2005 and 2009. According to the system of Gustilo and Anderson, 14 fractures were classified as type II, 43 as type IIIA, and three as type IIIB. Partial weight bearing with crutches was instructed when tolerable for dynamization. When there were evidences of fracture healing in both clinical and radiographic, external fixator was removed.

Results: All fractures united. The median union time was 12 weeks (range, 10-15) in type 11, 16 weeks (range, 10-24) in type IIIA, and 20 weeks (range, 20-21) in type IIIB. Iliac bone grafting was performed in six cases at a mean time of 3.8 weeks to enhance bone union. Seven cases (12%) developed pintract infections. No deep infection was found in the present study. Ninety-five percent of fractures united with less than 10 degrees angulation in any plane. No instrument failure was found. The external fixator frame could be reused.

Conclusion: The new design dynamic external fixator system successfully treated open tibial fractures with a good result and low complication rate. It is simple, safe, and easy to use.