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Treatment of type 3 open tibial fractures with dynamic axial fixator

Turkish Association of Orthopaedics and Traumatology
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The treatment of type 3 open tibial fractures of tibia is difficult with severe complications. In this study, we treated 20 type 3 open tibial fractures of 18 patients with dynamic axial external fixator. Fifteen patients were male and 3 were female. The mean age was 32.7 (range 16 to 60). According to Gustilo; 10 cases were type 3A, 7 cases were type 3B and 3 cases were type 3C. The follow-up period was ranging from 18 months to 10.5 years (mean was 38 months). Ten patients were re-operated for complications after primary procedures. In one case amputation was required. In four cases, stability could not be achived with fixator and additional percutaneous pinning were performed. Nonunion was observed in 3 patients (%15), osteomyelitis in 4 cases (%20). In 5 cases, multiple secondary soft tissue procedures were done. At the latest control, excellent results were obtained in 13 cases (%65), good results in 3 cases (%15), moderate in 2 cases (%10) and poor in 2 cases (%10) We think that dynamic axial external fixator is safe in the treatment of open tibial fractures and optimum soft tissue management and early motion can be achieved with this method. We also concluded that, good results can be achieved more than expectations in the treatment of these severe injuries with additional reconstructive procedures.

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