16- A COMPARATIVE STUDY FOR MANAGEMENT OF CLOSED TIBIAL SHAFT FRACTURES BY EXTERNAL FIXATION VERSUS PLATING......................................................................
Basrah Journal of Surgery,
2009, Volume 15, Issue 1, Pages 89-95
AbstractIn this prospective study, 25 patients with closed tibial shaft fractures were treated by two
different methods of treating fracture tibia ie, external fixation and plating. Thirteen patients were
treated by uniplanar unilateral external fixation device AO/ASIF type and 12 patients treated by
There were 22 male and 3 female, there age ranges from 12-45 years. Seventeen patients
sustain car accident as a cause of tibial fracture, associated fibular fractures were in 17
patients. There was no case of malunion in both modalities of treatment. Average time of
fracture union with external fixation was 24 weeks.
In external fixation union rate was 46%, delayed union 31% and non union 23%, complications
were pin tract infection 46%, ankle stiffness 31%, algodystrophy 31% and broken schanz
screws in 15.3%. Average time of fracture union with plating was 22.5 weeks.
In plating, union rate was 59%, delayed union 33% and non union 8%; while complications
were superficial infection 8%, deep infection 8% and ankle stiffness 8%. The non union was
100% in the middle 1/3 and 75% was transverse fracture configuration. The degree of soft
tissue injury, fracture site and configuration has a great effect on union, delayed union, non
union and infection also will affect the choice of treatment. In our study we try to evaluate two
different modalities of treatment, which are plating and external fixation as definitive method of
treatment of closed tibial shaft fracture and we try to compare between the 2 as regards of
different aspect like; time of union and complication in each modality and its relation with type of
fracture site, configuration, degree of soft tissue injury, this in turn will guide us to a better or
more proper choice of treatment modality in the future.
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