Immediate interlocking nailing versus external fixation followed by delayed interlocking nailing for Gustilo type...

Area of Science:

• Orthopedic Surgery
• Trauma Management
• Bone Healing

Background:

• Gustilo type IIIB open tibial fractures present significant treatment challenges.
• Optimal timing for surgical intervention remains a critical consideration.

Purpose of the Study:

• To compare the efficacy of immediate interlocking nailing versus delayed interlocking nailing after external fixation for Gustilo type IIIB open tibial fractures.

Main Methods:

• A cohort of 23 patients with Gustilo type IIIB open tibial fractures was analyzed.
• Patients were divided into two groups: immediate unreamed interlocking nailing (n=9) and external fixation followed by delayed unreamed interlocking nailing (n=14).
• Key outcomes assessed included time to union, deep infection rate, and nonunion rate.

Main Results:

• The mean time to union was 21 months (SD, 14) for immediate nailing and 14 months (SD, 8) for delayed nailing.
• Nonunion rates were 44% (immediate) and 36% (delayed), while deep infection rates were 22% (immediate) and 7% (delayed).
• No statistically significant differences were observed between the two treatment groups for any of the measured outcomes.

Conclusions:

• Current data suggest no significant difference in outcomes between immediate and delayed interlocking nailing for Gustilo type IIIB open tibial fractures.
• Prospective, randomized, multicenter studies are required to definitively establish the superiority of one treatment method over the other.