Treatment of Open Tibial Fractures: Converting or Continuing External Fixation?

Background: The treatment of open tibial fractures is still an orthopaedic cha llenge and full of compl icat ions. In many cases the use of external fixator that has been known as a nonunion machine is obligatory with a high incidence of pin track infection and other complicat ions. The aim of this study was to compare the use of extern al fi xation as a definite method for treatment of open tibial fracture s with its subsequent convers ion to internal fixation or casting. Methods: Sixty-seven young patients with type III open tibial fractures (Gusti lo-A nderson classification) were treated with half pin external fixation. Twenty of them were convert ed into internal fi xation after a period of 6-8 weeks. For another twenty-fi ve. external fixator was removed and treatment continued with casting for a period lasting from 16 to 20 weeks. And for twenty two patients the fixator continued until complete union. The patients followed up for 10-16 months and were evaluated in terms of union time, union rate, infection, range of motion, malunion, non-union, nerve injury, and reduction. Results: There was a meaningful difference only in the union time and superficial infection between the first grou p and the other two groups. Conclusion: The conversion of external to internal fixation can be considered as a safe, effec tive, Jess complicated, and more acce ptable method for the treatment of open tibial fractu res.