STUDY OF MANAGEMENT OF OPEN TYPE IIIa AND TYPE IIIb FRACTURE OF TIBIA BY LIMB RECONSTRUCTION SYSTEM

Abstract

Background: Management of compound tibia and femur fractures is difficult due to the presence of infection, bone loss, shortening and multiple surgeries in the past .open wound of lower limb are traditionally managed by Ilizarov fixation. The disadvantages of Ilizarov are poor patient compliance, inconvenience of the frame and difficult frame construction. We conducted a study on 20 compound tibia and femur fractures treated by the limb reconstruction system (LRS). Method and Materials: A prospective analysis of compound fracture of tibia type IIIa and III was done, cases treated from jan 2012 to june 2016 were included, which were treated with LRS application. this patient who had a minimum period of 6-24 month follow up from the day of initiation of treatment. 10 cases of compound tibia IIIa and 10 cases 0f IIIb were included in study . status of wound was classified by Gustello -Anderson open wound criteria ,comorbidies were noted ,additional procedure if any were noted. radiological union was defined as minimum of 3 cortical continuity in views of X-Ray. time duration was recorded in which knee Range of motion was assessed by ‘hand goniometry during treatment. Result: Average age of patient was 37.9 year , tibial showed total 100% fracture united. Average time tibial union was 10.2 month . Average time for tibial LRS in situ was 10.6 month . 6 patient required corticotomy with lengthening .Average lengthening was 2.5 cm in 7 no cases (1.5-5 cm range). Average knee rom is 100 degree of flexion(range90-130) complication noted were 1) pin tract infection 2) Delayed or Non union 3) multiple surgeries 4) patients co-operation