Evaluation of the comparative results of ender’s nailing and AO type external fixator in the management of open fractures of the tibial shaft. (Gustilo type II, type IIIA and type IIIB): A comparative study

Abstract

Background: Open tibia fracture, due to high energy or low energy trauma classified according to Gustilo-Anderson classification system. There are five keys to successful treatment: antibiotic therapy, radical debridement and pulsed lavage irrigation, stabilization of fracture with minimal further devascularization, early soft tissue coverage and early bone-grafting. Methods: The study included a total 24 patients of open fracture of tibia shaft type II, IIIA and IIIB (Gustilo) managed in IMCHRC Indore from 01/09/2018 to 01/09/2019. In these study we include pt. of both sex (19 males & 5 females). Results: Open tibia fractures were mostly in males (79.2%) where 70% were young patients with a mean age of 37 yrs. Among these patients 75% sustained high velocity injury. Mean period of fracture union in ENDERS group were 24.05 weeks (range 22 to 28 weeks) while in external fixator group was 27.08 weeks (range 29 to 30 weeks). Among these 24 cases infection detected in 3 cases (all were treated by external fixator; 06 cases belong to Gustilo-Anderson III group). 33.33% mal-alignment in external fixator group in comparison to 16.6% in patients treated with ENDERS nail. Conclusion: Open tibia fracture treated with ENDERS nail united earlier than external fixator and total number of secondary surgeries to achieve union in ENDERS nail was significantly lesser than external fixator group. Infection and mal-alignment rate was also high in external fixation cases.