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16- A COMPARATIVE STUDY FOR MANAGEMENT OF CLOSED TIBIAL SHAFT FRACTURES BY EXTERNAL FIXATION VERSUS PLATING......................................................................

ALAA ABDUL HUSSAINt

Basrah Journal of Surgery مجلة البصرة الجراحية
ISSN: 16833589 Year: 2009 Volume: 15 Issue: 1 Pages: 89-95
Publisher: Basrah University جامعة البصرة

Abstract

In this prospective study, 25 patients with closed tibial shaft fractures were treated by twodifferent methods of treating fracture tibia ie, external fixation and plating. Thirteen patients weretreated by uniplanar unilateral external fixation device AO/ASIF type and 12 patients treated byplating.There were 22 male and 3 female, there age ranges from 12-45 years. Seventeen patientssustain car accident as a cause of tibial fracture, associated fibular fractures were in 17patients. There was no case of malunion in both modalities of treatment. Average time offracture union with external fixation was 24 weeks.In external fixation union rate was 46%, delayed union 31% and non union 23%, complicationswere pin tract infection 46%, ankle stiffness 31%, algodystrophy 31% and broken schanzscrews 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 complicationswere superficial infection 8%, deep infection 8% and ankle stiffness 8%. The non union was100% in the middle 1/3 and 75% was transverse fracture configuration. The degree of softtissue injury, fracture site and configuration has a great effect on union, delayed union, nonunion and infection also will affect the choice of treatment. In our study we try to evaluate twodifferent modalities of treatment, which are plating and external fixation as definitive method oftreatment of closed tibial shaft fracture and we try to compare between the 2 as regards ofdifferent aspect like; time of union and complication in each modality and its relation with type offracture site, configuration, degree of soft tissue injury, this in turn will guide us to a better ormore proper choice of treatment modality in the future.