EVALUATION OF AO EXTERNAL FIXATOR IN THE MANAGEMENT OF OPEN DIAPHYSIAL FRACTURE OF TIBIA GUSTILO TYPE IIIA AND IIIB

Abstract

Background: Initial management by external fixation is well-established but high incidence of pin tract infections, thermal necrosis of bone and potential of mal-union and non-union are the main complications. This study was conducted to evaluate the result of AO external fixator in open diaphysial fracture of tibia Gustilo type IIIA and IIIB.
Material & Methods: This descriptive cross-sectional study was carried out in Department of Orthopaedic Surgery and Traumatology Unit-I, Liaquat University Hospital, Hyderabad, Jamshoro, from October 2010 to September 2012. Thirty patients with open diaphysial fracture of tibia Gustilo type IIIA and IIIB as assessed by pre-operative workup and operative findings were treated by AO external fixator. After admission, history, clinical examination, routine investigations and x-ray findings were noted. Data was entered in a proforma and analyzed by SPSS software.
Results: Out of 30 patients, 25(83.3%) were males and 5(16.7%) females; with male to female ratio of 5:1. The mean age was 34.75+5.8 years. Regarding mode of injury, 23(76.66%) patients sustained injury following road traffic accident, 6(20%) following fall and one (3.33%) with a firecracker injury. The type of fracture was Gastilo type-IIIA in 11(36.66%) and IIIB in 19(63.33%) cases. Regarding anatomical location of fracture, middle-third of the tibia in 18(60%), distal-third in 7(23.33%) and Proximal-third in 5(16.66%) cases. Complications seen were pin track infection in 2(6.66%), wound infection in 4(13.33%), non-union in one (3.33%), mal-union in one (3.33%) and delayed union in 3(10%) cases.
Conclusion: AO external fixator is simple and safe to apply and can be used as successful management of type III open tibial fractures confidently.