Management of Tibial Fracture due to High Velocity Speed War Injuries

Abstract

Abstract:Background: Fractures of tibia are very common in patients with war trauma, because the only expose part remain of the body are the limbsObjective: To evaluate the use of external fixation device as the initial and definitive method of treatment of these fracturesMethods: Fifty-nine high-velocity tibial war injuries fractures (11 closed and 48 open) in 51 patients were treated with the external fixation devices of different varieties (mainly AO, Orthofix, Strayker), in al Yarmouk teaching hospital between 2005 and 2006. Open wounds were debried and tension free primary closure using interrupted nylon sutures was attempted wherever appropriate. In others, either split thickness skin grafting or local gastrocnemius flaps were used. Early weight bearing with range of motion exercises of ankle and knee joints were encouraged.Results: Average fracture healing time was 6.25 months (range 4–8.5 months). Based on Johner and Wruh's Criteria, there were (37 excellent 62.7%), (18 good 30%), (2 fair 3.3%), and (2 poor results 3.3%). Complications included pin tract infection (17 case 28.8%), knee joint stiffness (9 cases 15%), shortening (7 cases 11.8%), and ankle joint stiffness (4 cases 6.7%).Conclusion: External fixation provided early and definitive fixation for high-velocity speed tibial fractures with good results.Keywords: External fixation, tibial fractures, war injuries