Treatment of intraarticular distal tibial fractures by external fixation

Summary

OBJECTIVE:
A retrospective clinical study evaluate two types of external fixation in high energy injury of distal tibial fractures treated in Traumatological hospital Brno on Clinic of Trauma Surgery, Medical Faculty Masaryk University Brno. Authors evaluate duration of the fracture healing process and the incidence of complications.

MATERIAL AND METHODS:
The patients with distal tibial fractures type C2 and C3 according to AO classification were treated by two types of external fixation - ankle spanning and ankle sparing fixation. Clinical evaluation was achieved by Weber´s protocol.

RESULTS:
Authors present a study involving 34 patients. All fractures healed. The average time of fixation was 14 weeks. Pin tract infect were occurred in 13 patients and deep infection in two patients. In closed fracture with ankle sparing fixation were 69 % patients with excelent and good results according to Weber´s protocol. In closed fractures with ankle spanning fixation were 61 % patients. In open fractures group were excelent and good results in patients with ankle sparing fixation in 58 % and in ankle spanning fixation in 53 %. Delayed union were observed in 4 patients and enforced spongioplasty. In two cases were necessary performed medial plate stabilisation.

CONCLUSION:
Our study confirmed good results in treatment high energy distal tibial fractures by ankle sparing external fixation. The benefits of this type of external fixation were low incidence of complications and early movement of ankle. The application of external fixation is safety method appropriate for treatment of intraarticular distal tibial fractures and open fractures.

Key words:
external fixation, distal tibial fracture.