A PROSPECTIVE CASE SERIES ON THE DEFINITIVE USE OF EXTERNAL FIXATION AND VACUUM-ASSISTED CLOSURE IN OPEN TIBIA FRACTURES
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Keywords
Open Tibia Fracture, External Fixator, Vacuum-Assisted Closure Dressing, Skin Grafting, Negative Pressure Wound Therapy.
Abstract
Introduction
Open fractures of the leg are quite common in road traffic accidents; the treatment of open tibial shaft fractures is very challenging, especially in developing countries where medical equipment's and orthopaedic experts are scarce, and there is a poor economy and health-seeking behaviour. The ideal protocol for open fractures of the leg is initial thorough debridement, soft tissue coverage, and intramedullary nailing or external fixator application. However, external fixators are comparatively safe in treating tibial open injuries; meanwhile, they have the advantages of minimal disruption, convenient subsequent soft tissue repair, and easy application. However, the procedure is accompanied by a serious number of problems in bone healing, alignment, and pin tract infections. Therefore, this study aimed to assess the outcome of open tibial shaft fractures treated by using external fixation as a primary and definitive treatment. The aim of this study was to evaluate the effectiveness of a uniplanar external fixator with vacuum-assisted closure application as a primary and definitive treatment for Gustilo and Anderson compound grade III B open tibial fractures.
Methods
This is a prospective study. We included all patients who underwent management for open tibial shaft fractures between April 2023 and April 2024. All the cases that were treated with uniplanar external fixators. Initial debridement with vacuum-assisted closure application was done.
Results
Ten patients with open fractures of the tibia-fibula were considered. Primary fixation of bones was done with a uniplanar external fixator and vacuum-assisted dressing, followed by split skin grafting. The use of a uniplanar external fixator with a vacuum-assisted closure dressing allows for stable fixation while minimising the risk of infection and further damage to surrounding tissue.
Conclusion
External fixators are a safe option as a primary and definitive mode of treatment in Gustilo type IIIB open fractures of the tibia.
References
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Dr. Sandeep Patil V.
Associate Professor, Department of Orthopaedics, Sri Madhusudan Sai Institute of Medical Sciences and Research, Chikkaballapur, Karnataka, India.
Dr. Narendra B. S.
Senior Resident, Department of Orthopaedics, Sri Madhusudan Sai Institute of Medical Sciences and Research, Chikkaballapur, Karnataka, India.
Dr. Varun V.
Senior Resident, Department of Orthopaedics, Sri Madhusudan Sai Institute of Medical Sciences and Research, Chikkaballapur, Karnataka, India.