Significance of fracture gap in open tibial fracture

The healing pattern of medial and lateral cortical gap in open transverse or short oblique tibial fractures were retrospectively reviewed in 2 groups; In group A, 16 patients were treated by Judet external fixator in rigid mode. In group B, 6 patients were treated in biocompressive mode, which allowed predominantly longitudinal axial motion. The characteristic healing pattern in group A was gap healing without or with minimal periosteal callus. The healing time and time for consolidation per 1mm gap were significantly longer in medial cortices than lateral ones (p < 0.036, p < 0.024 respectively). In group B, the fractures were healed with periosteal callus. There was no difference in the healing time and the time for consolidation per 1mm gap between the two cortices. The consolidation time per 1mm gap in the medial cortices was significantly longer in group A than group B (p < 0.020). The longitudinal axial motion in open transverse tibial fractures seems to shorten the healing time effectively in the medial cortex.