Outcome of Type 3 Open Tibial Diaphyseal Fractures Managed with a Limb Reconstruction System: Analysis of a 49-Patient Cohort

Abstract

Objective: To evaluate functional and radiological results following treatment with the single-plane external fixator limb reconstruction system (LRS) for open tibial diaphyseal fractures resulting from high-energy trauma. Subjects and Methods: From a total of 62 patients who were operated on between 2011 and 2014 for open tibial diaphyseal fractures resulting from high-energy trauma, 50 tibias from 49 patients (males: 32, females: 17) were classified as type 3 according to the Gustilo-Anderson open fracture classification, and definitive treatment was applied with the LRS. The patients ranged in age from 20 to 36 years. Time to union, time of external fixator usage, complications and functional results according to the Johner-Wruhs criteria were recorded. Results: The mean follow-up period was 23 ± 12 months (range: 11-44). Of the 50 tibias, full union was achieved with the LRS in 48 (96%). No shortness or deformity was observed in any patient. Knee and ankle range of movement were measured as full in all patients at the final follow-up examination after removal of the LRS. The mean time to union was 20.4 ± 4 weeks (range: 16-24). The mean time of external fixator use was 20 weeks (range: 16-24 weeks). Conclusion: In this study, for the definitive treatment of open tibia diaphyseal fractures, the LRS was an optimal and safe choice that offered single-stage surgery.