Delayed Reamed Interlocking Nailing after Initial External Fixation in Gustilo-Anderson Type III B Open Tibial Shaft Fractures

Abstract

Background: To evaluate union and infection rates in Gustilo – Anderson type III B open tibial shaft fractures treated by delayed interlocking nailing after initial external fixation.
Materials and Methods: Twenty-five patients who had sustained type III B open fractures of the tibial shaft were treated with external fixation as a temporary stabilization with conversion to reamed interlocking nailing later were retrospectively studied. Once the wounds had healed the external fixator was removed, plaster of Paris posterior slab was applied and after the pin tracts had healed closed reamed interlocking nailing was done
Results: Union occurred in twenty-four patients [96%]. Infection occurred in three patients [12%]. Additional unplanned surgeries included nail removal and intra medullary reaming in three patients for infection, conversion to Ilizarov ring fixator in one patient and additional skin grafting surgery in one patient
Conclusions: Delayed interlocking nailing after initial external fixation gives a good union rate but increased incidence of infection in Gustilo – Anderson type III B open tibial fractures.