FUNCTIONAL OUTCOME OF COMPOUND FRACTURES OF TIBIA TREATED BY EXTERNAL FIXATION

Abstract

Tibial fractures are among commonly occurring long bone fractures which frequently present as open fractures due to subcutaneous nature of tibia and increasing high velocity trauma in road trafc accident. The precarious blood supply and lack of soft tissue cover of the shaft of tibia and increased incidence of open fracture make it difcult for treatment and high rate of non-union and infection. So aggressive treatment with adequate wound debridement and IV antibiotics and fracture stabilization is necessary. Various methods for fracture stabilization include plating , intra-medullary nailing or external xator application. This prospective study was done among 39 patients who sustained compound tibial fractures(Gustilo grade II , IIIa and IIIb) and were admitted in Department of Orthopaedics, Government Medical College, Thrissur. Functional and clinical outcome is assessed at 1st and,2nd week followed by 1st , 3rd & 6th months using modied johner and wruh's criteria.The post operative outcomes- intermediate and nal, were assessed and analysed for statistical signicance using Microsoft Word, Microsoft Excel and statistical software IBM-SPSS (International Business Machines- Statistical Product and Service Solutions) ver18, using appropriate statistical tests. The patients were in the age group of 23 to 63 years and with a mean age of 41.59 years. Males were predominant. Most common mode of injury is road trafc accident which accounts for 71.8% of cases. Majority of injury were type 2 (61.5%) Gustilo-Anderson classication. There were 12.8% Excellent results, 38.5% Good results, 10.3% Fair results and 38.5% Poor results according to Modied Johner and wruh's criteria. External xation is a simple and effective means of treating of open tibial shaft fractures especially in type 2 , type 3A & type 3B fractures, the external xator as a treatment in open tibia fracture is a valuable tool as it gives advantage to less operative time and intra-operative blood loss. There is easy access to the soft tissue and easy wound management with a stable xation can be obtained