Problems related to pin setting and frame form in treatment of tibiofibular fractures by external fixation:a retrospective analysis of 3003 cases

Abstract

Objective To analyze the problems related to pin setting and frame form in treatment of tibiofibular fractures by external fixation. Methods From January 1999 to December 2010, 3003 cases of tibiofibular fracture were treated in our center by external fixation. They were 2417 males and 586 females with an average age of 29. 1 years (range, 3 to 78 years). By Gustilo classification, there were 232 cases of type Ⅰ, 837 cases of type Ⅱ, 712 cases of type Ⅲ A, 1159 cases of type ⅢB and 63 cases of type Ⅲ C.Problems that had occurred during the period of external fixation were analyzed and grouped according to pin setting and frame form. Results The external fixators of the 3003 cases were grouped into monolateral,circular and hybrid forms. The predominant form was monolateral, used in 2292 cases (76. 3% ). There were totally 1253 problems related to pin setting and frame form. The most problems (423) were insufficient inter-pin distance, followed by invasion to the donor site at the leg (233) and insufficient included angle between wires (123) . These problems resulted in decreased strength of the frame and difficulty in design of secondary flaps at the leg. Conclusion As external fixation has been widely used for open fractures of the leg, problems related to pin setting and frame form should be avoided as much as possible by meticulous operation and sufficient experience to improve the efficacy of external fixation. Key words: Tibia; Fractures; External fixatiors