Type III-B open tibial fractures in Mozambique. A prospective study of 50 cases

We have studied prospectively 50 cases of open tibial fractures Type-III B. Treatment was based on the principles of debridement, wound irrigation, fracture stabilisation (generally by external fixation) and 'early bone coverage' without skin sutures. The cases were divided into two groups: Group 1: Eight fractures with segmental bone defects treated by bone transport using the Ilizarov technique or by intertibial-fibular bone grafting, and group 2: Forty-two fractures with defects of soft tissue coverage without segmental bone defects treated with simple closure or myoplasty. Union was achieved in Group 1 in an average of 16 months (range 6-21.5), and in an average of 5.6 months (range 3-10) in Group 2. The most frequent complication was malunion in angulation which occurred in 11 cases (22%). There was an equinus contracture of the ankle in 8 cases (16%) and chronic osteomyelitis occurred in 5 (10%). Adequate union was achieved in all but one case.