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Sequential intramedullary nailing of open tibial shaft fractures after external fixation

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Abstracts

We reviewed 32 tibial shaft fractures in 31 patients treated with sequential intramedullary nailing after primary external fixation. There were 30 open fractures and 2 closed injuries with severe blunt trauma requiring fasciotomy. Fifty per cent of the fractures were classified as Gustilo type III A and B injuries [13]. The mean external fixation treatment averaged 6.6 weeks, and secondary intramedullary nailing was done on average 7.4 weeks after injury. In 50% of the fractures, secondary nailing was done at the same procedure as removal of the external fixation. Overall, the incidence of osteomyelitis and nonunion was 3.1% each and of malunion 19%. The time to full weight-bearing averaged 31.2 weeks. The results were separately analyzed according to Gustilo types and subtypes. In the Gustilo type III B injuries, the incidence of osteomyelitis and non-union was 11 %, while malunion occurred in 33%. The time to full weight-bearing averaged 53 weeks. These results support the conclusion that this treatment modality is a valid alternative to other treatment options. However, previous pintract infections should be regarded as a contraindication for secondary nailing.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Inselspital, University of Bern, CH-3010, Bern, Switzerland

    K. A. Siebenrock & R. P. Jakob

  2. Unfallchirurgische Klinik der Medizinischen Hochschule, Hannover, Germany

    T. Gerich

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  1. K. A. Siebenrock
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  2. T. Gerich
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  3. R. P. Jakob
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Siebenrock, K.A., Gerich, T. & Jakob, R.P. Sequential intramedullary nailing of open tibial shaft fractures after external fixation. Arch Orthop Trauma Surg 116, 32–36 (1997). https://doi.org/10.1007/BF00434097

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  • DOI: https://doi.org/10.1007/BF00434097

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