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European Journal of Trauma and Emergency Surgery

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05-07-2023 | Tibia Fracture | Original Article

Monolateral external fixation versus internal fixation of Gustilo IIIB open tibial fractures: a multicenter comparative study

Authors: Olaoluwa Moses Shodipo, Mosimabale Joe Balogun, Ali Mohammed Ramat, Shaphat Shuaibu Ibrahim, Hamzah Ibrahim Jatto, Lukman Olalekan Ajiboye, Mahamud Abiodun Lawal, Omolade Ayoola Lasebikan

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2024

Abstract

Purpose

Gustilo IIIB open tibial fractures are associated with significant risks of complications particularly nonunion and fracture-related infections (FRI) due to the severity of the injuries. The commonly adopted viewpoint is that a Gustilo IIIB open tibial fracture is a relative contraindication for internal fixation. However, this study aims to assess the veracity of this viewpoint. The objective of this study was to evaluate the impact of the definitive fixation technique on fracture nonunion and FRI rates in Gustilo IIIB open tibial fractures. In this study, we compared the rates of nonunion and FRI rates in grade IIIB open tibial fractures managed definitively with either mono-lateral external fixation or internal fixation.

Methods

The study was a multicenter retrospective comparative study undertaken in seven Nigerian tertiary hospitals. Following ethical approval, medical records of patients diagnosed with Gustilo IIIB open tibial fractures (between 2019 and 2021) were retrieved, patients who had a minimum of nine months of follow-up period and were found eligible had their relevant data entered into an online data collection form. Data obtained was analysed with SPSS version 23, and chi-square test was used to determine the statistical significance of differences observed between the two groups with regard to nonunion and FRI rates. P values less than 0.05 were considered statistically significant.

Results

Out of a total of 47 eligible patients, 25 patients were managed definitively with mono-lateral external fixation whilst 22 patients were managed with internal fixation. Five of the 25 patients (20%) managed with external fixation had nonunion whilst two cases of nonunion were recorded amongst the 22 patients (9.1%) treated with internal fixation. The difference between the two techniques with regard to nonunion rates was not statistically significant (P = 0.295). 12 out of 25 patients (48%) in the external fixation group had FRIs whilst 6 out of 22 patients (27.3%) in the internal fixation group had FRIs. The rates of FRIs of the two groups were not significantly different (P = 0.145).

Conclusion

Our findings suggest that mono-lateral external fixation and internal fixation do not differ significantly with respect to rates of nonunion and fracture-related infections in Gustilo IIIB open tibial fractures.

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Title: Monolateral external fixation versus internal fixation of Gustilo IIIB open tibial fractures: a multicenter comparative study
Authors: Olaoluwa Moses Shodipo
Mosimabale Joe Balogun
Ali Mohammed Ramat
Shaphat Shuaibu Ibrahim
Hamzah Ibrahim Jatto
Lukman Olalekan Ajiboye
Mahamud Abiodun Lawal
Omolade Ayoola Lasebikan
Publication date: 05-07-2023
Publisher: Springer Berlin Heidelberg
Keyword: Tibia Fracture
Published in: European Journal of Trauma and Emergency Surgery / Issue 1/2024
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-023-02323-8

2024 ASCO Annual Meeting

Springer Medicine

Monolateral external fixation versus internal fixation of Gustilo IIIB open tibial fractures: a multicenter comparative study

Abstract

Purpose

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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