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ORIGINAL ARTICLE
Year : 2015  |  Volume : 15  |  Issue : 3  |  Page : 262-268

Comparative studies on intramedullary nailing versus ao external fixation in the management of gustilo type II, IIIA, and IIIB tibial shaft fractures


1 Department of Orthopedics, Burdwan Medical College and Hospital, Burdwan, India
2 Department of Physiology, Burdwan Medical College and Hospital, Burdwan, India
3 Department of Pathology, Burdwan Medical College and Hospital, Burdwan, India
4 Department of Orthopedics, IMSR Medical College, Mayani, Satara, India

Correspondence Address:
Arunima Chaudhuri
Krishnasayar South, Borehat, Burdwan - 713 102
India
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DOI: 10.4103/1319-6308.164303

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Background: Tibial diaphyseal injuries with severe open fractures have always been a troublesome concern for treatment. Aims: The aim was to compare results of external fixator and unreamed interlocking nail in treating Gustilo type II, type IIIA, and type IIIB tibial diaphyseal fractures to come to a conclusion to establish their appropriateness in the respective fractures. Materials and Methods: This pilot project was conducted in a tertiary care hospital of eastern India after taking institutional ethical clearance and informed consent of the subjects. Forty-five patients were selected. Results: A total of 23 cases were treated by external fixator and 22 cases were treated by unreamed solid interlocking nail. A total of 14 cases, that is, 31% showed delayed union. Type II injury 3/15 = 20%; Type IIIA injury 6/22 = 27.3%; Type IIIB injury it is -5/8 = 12.5%. For cases treated with unreamed nail it was 22.7%; external fixator it was 39.1% among 45 cases, 05 cases showed nonunion. For cases treated with unreamed nail it was 13.6%; external fixation it was 8.7%. The overall rate of deep infection is 11.1%. The rate in interlocking nail was 13.6%, and external fixation was 8.7%. Reoperation in the form of dynamization and bone graft application after 20 weeks in unreamed nail was 36.4%, whereas in external fixation the rate was high, almost 48%. The average time of union with unreamed interlocking was about 25.4 weeks, wherein external fixation it was 28.6 weeks. Conclusions: Though external fixators are good and reliable method of stabilization of Gustilo type II, type IIIA, and type IIIB tibial diaphyseal fractures, unreamed interlocking intramedullary nail yields better results in treating Gustilo type II and type IIIA tibial shaft fractures.


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