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Open tibial fractures treated with Hoffmann external fixation.

A Nesbakken1, A Alho, A J Bjersand

  • 1Department of Orthopedics, University Hospital of Bergen, Haukeland Hospital, Norway.

Archives of Orthopaedic and Traumatic Surgery. Archiv Fur Orthopadische Und Unfall-Chirurgie
|January 1, 1988
PubMed
Summary

External fixation effectively treated open tibial shaft fractures, achieving wound healing within 18 weeks. Alertness for early fasciotomy is crucial, and external fixation duration should be minimized for optimal outcomes.

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Area of Science:

  • Orthopedic Surgery
  • Trauma Care

Background:

  • Open tibial shaft fractures present significant treatment challenges.
  • Management requires addressing both bone and extensive soft-tissue injuries.

Purpose of the Study:

  • To evaluate the outcomes of external fixation for open tibial shaft fractures.
  • To identify factors influencing treatment success and complications.

Main Methods:

  • Retrospective analysis of 32 patients treated with external fixation between 1973 and 1981.
  • Assessment of wound healing, time to weight-bearing, infection, union, and functional outcomes.

Main Results:

  • Wound healing achieved in most patients within 18 weeks, with a median time to full weight-bearing of 32 weeks.

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  • Two deep infections resolved; one early amputation was necessary.
  • Functional outcomes varied, with 17 excellent/good results but 5 poor outcomes, four linked to compartment syndrome-induced stiffness.

    • Conclusions:

    • External fixation is a viable option for open tibial shaft fractures, even with soft-tissue compromise.
    • Early fasciotomy is essential for severe injuries to prevent complications like compartment syndrome.
    • Prolonged external fixation should be avoided; duration should align with soft tissue and bone healing needs.