Objective To observe the clinical efficacy of an adjustable combined external fixator in treating open tibiofibular shaft fractures.
Methods The data of 38 open tibiofibular shaft fractures patients with grading Gustilo Ⅰ and Ⅱ was retrospectively analyzed, and all the patients were treated with adjustable combined external fixators. The wounds got debrided and the external fixator got installed on the tibia. The fixator would be simplified when a small amount of porosis was observed by X ray. Clinical healing standard was achieved when X ray findings showed that the callus passed through the fracture and the line of fracture had disappeared or almost disappeared, and fixator got removed.
Results The average age of 38 patients was(43.89±10.99)years, and the mean follow-up period was(47.84±9.20) weeks. Fracture broken ends of all cases achieved bone union except one of them occurred osteomyelitis. The average fixation time was (17.53±2.95) weeks, and average time of wearing external fixator was (21.53±2.63) weeks. The clinical evaluation of the latest follow-up was performed by Johner-Wruhs score, which included excellent efficacy in 23 cases, good efficacy in 8 cases, fair efficacy in 6 cases and bad efficacy in 1 case, with excellent rate of 81.58%. Two cases got slight infection around the nail paths, and were cured after debridement and antibiotics treatment. One case got refracture after the fixator removed and healed well after plaster external fixation combined with protective devices in latter healing period. One case occurred wound infection and developed into osteomyelitis finally, and had better prognosis after debridement and osteotomy.
Conclusion The adjustable combined external fixator as a ultimate treatment for open tibiofibular shaft fractures can reduce the blood supply damage of the fracture end, decrease the incidence of infection and the probability of second operation, and shorten the fixation time of the external fixator and the healing time of the fracture end.
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