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Sequential In vivo Imaging of Osteogenic Stem/Progenitor Cells During Fracture Repair
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Sequential management of tibial fractures using a temporary unicortical external fixator
Anne-Pauline Russo1, Alexandre Caubere2, Ammar Ghabi1
1Department of Orthopedic Surgery, Traumatology and Reconstructive Surgery, Percy Military Hospital, Clamart, France.
SICOT-J
|September 8, 2018
Summary
Temporary unicortical external fixators (TUEFs) reliably maintain tibial fracture reduction for early conversion to intramedullary nailing. However, TUEFs do not prevent sepsis in severe soft tissue injuries.
Area of Science:
- Orthopedic Surgery
- Trauma Management
- External Fixation Devices
Background:
- Damage control orthopedics (DCO) promotes temporary external fixation to limit infection and enable later internal fixation.
- Temporary unicortical external fixators (TUEFs) were developed to address these goals in tibial fracture management.
Purpose of the Study:
- To evaluate the reliability of TUEFs in maintaining tibial fracture reduction.
- To assess the feasibility of early conversion to intramedullary (IM) nailing after TUEF application.
- To analyze infectious complications associated with TUEF use in tibial fractures.
Main Methods:
- Retrospective study in two French military trauma centers.
- Inclusion of patients with tibial fractures treated with TUEF (UNYCO®) followed by early IM nailing.
- Analysis of fracture reduction, conversion timing, union rates, and complications.
Main Results:
- 12 TUEFs implanted in 11 patients (average age 41) with open (11) and closed (1) tibial fractures.
- Early conversion to IM nailing averaged 7.6 days with stable reduction maintained.
- All fractures achieved bone union; two cases of pandiaphysitis were treated successfully without functional deficit.
Conclusions:
- TUEFs are reliable for maintaining tibial fracture reduction and facilitating early IM nailing.
- Unicortical fixation does not prevent septic complications, which are linked to soft tissue injury severity.
- Further research with larger cohorts is warranted.
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