Treatment of grade 3a and 3b compound tibial fractures with external fixation and primary immediate bone grafting

Rajul Gupta, Vaibhav Maheshwari, S. Gour, Deepak Nadkarni, K. Verma
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Abstract

Introduction- The present study report results of a series of type 3A and 3B open fractures treated with debridement and fracture fixation and immediate bone grafting. Methods- Twenty one patients were treated from January 2017 to January 2018. All fractures were treated with a modular external fixator. Nine fractures were type 3A and 12 were type 3B. All fractures received debridement, external fixation, bone grafting and flap or skin graft coverage. All fractures were analyzed for time to fracture union, incidence of pin tract infection, incidence of wound infection, flap complications, and delayed or non union. Results- After a mean follow up period of 14 months (range 12 to 16 months), it was concluded that the time to fracture union was 22 weeks, and all fixators were removed only after radiological evidence of fracture union. 1 (5%) patients developed deep wound infection, one experienced delayed union. Conclusion- Along with early wound coverage and external fixation, primary bone grafting can be employed in grade 3 open fractures of tibia with good results and without any increased risk of wound complications ………………………………………………………………………………………………………………………...............
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外固定+一期即刻植骨治疗3a级、3b级复合胫骨骨折
本研究报告了一系列3A和3B型开放性骨折的清创、骨折固定和即刻植骨治疗的结果。方法:2017年1月至2018年1月对21例患者进行治疗。所有骨折均采用模块化外固定架治疗。9例为3A型,12例为3B型。所有骨折均行清创、外固定、植骨及皮瓣或植皮覆盖。分析所有骨折骨折愈合时间、针道感染发生率、伤口感染发生率、皮瓣并发症、延迟愈合或不愈合。结果-平均随访14个月(12 - 16个月),结论是骨折愈合时间为22周,只有在有骨折愈合的放射证据后才拆除所有固定物。1例(5%)患者发生深部伤口感染,1例延迟愈合。结论——连同早期伤口覆盖和外固定,主要可以使用骨移植在三年级开放骨折的胫骨,效果很好,没有任何伤口并发症的风险增加 ......................................................................................................................................................
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