Secondary Intramedullary Nailing After Primary External Fixation In The Treatment Of Tibial Fractures

Abstract

Results of the treatment of 10 open tibial fractures are reported. Initial treatment involved application of external fixator, debridement of wound and parental antibiotic administration. Secondary procedure was carried out on an average of 8 weeks after the initial procedure. Secondary intramedullary interlocking nailing was done with Gross-Kempf tibial nail. All fractures united at an average of 14 months after secondary procedure. Pin tract infection was seen in four cases and was treated with appropriate antibiotics in three patients and removal of nail in one case. More than five degree deformity in the coronal plane was seen in two cases and 10 degrees of sagittal plane deformity in one case. The over all functional outcome was satisfactory in this series. The findings of the study suggest that primary external fixation followed by secondary intramedullary nailing is a viable option in open tibial fractures in adults.