External fixation for tibial fractures: clinical results and cost effectiveness

We report our experience with the Orthofix external fixator in the management of closed and Gustilo grades 1 and 2 compound unstable tibial shaft fractures. Forty-four fractures were treated between January 1988 and December 1989. All the fractures united. Median time in hospital was 13 days. Median time to union was 21 weeks for closed and 22 weeks for compound fractures. A method of estimating the overall cost per patient is described. Using this method we compared the cost of using the Orthofix with that of intramedullary nailing and plating according to AO principles. The Orthofix fixator was cheaper than alternative methods in particular because no readmissions were required for implant removal.