Open tibial shaft fractures rank as the most common fractures of the locomotor system. External skeletal fixation, after primary open fracture wound management, stands for a good method in the management of open tibial shaft fractures, as it does not poses an additional threat to the bone vascularisation in the fracture area, which is important for wound healing and reduction of deep infection occurrence percentage. The paper presents a nineteen-year-old patient who sustained an open right tibial shaft fracture in a motorcycle accident when he ran into a car. After performing an x-ray examination and short preoperative preparation, we proceeded to primary open fracture wound management, bloody reposition of tibial fragments and external fixation by unilateral external skeletal fixator with convergent pin orientation. Early postoperative course was uneventful. Twenty days following the external fixation, the patient fell while getting out of the car, when his crutch stuck in the metal fence. On control x-ray examination, a dislocation of tibial fragments was seen at the fracture site. After the administration of appropriate analgesic therapy and loosening the external fixator clamps, a correction of fracture dislocation was performed. On control x-ray examination, a good position of fragments after correction was observed. The unilateral external skeletal fixator “Mitković” produced by “Trafix” firm enables a simple correction of fracture dislocation, without performing additional surgical procedures.
Gustilo RB, Anderson JT. Prevention of infection in the tratment of one thousend and twenty-five open frac tures of long bones. Retrospective et prospective analayses. J Bone Joint Surg Am. 1976;58:453–8.
2.
Caudle RJ, Stern PJ. Severe open fractures of the tibia. J Bone Joint Surg Am. 1987;69:801–7.
3.
Fischer MD, Gustilo RB, Varecka TF. The timing of flap coverage, bone grafting and intramedullary nailing in patients who have a fractura with extensive soft-tissue injury. J Bone Joint Surg Am. 1991;73:1316–22.
4.
Treatment og grade IIIb open tibial fractu res.A prospective randomized comparasion of external fixation and non-reamed locked nailing. J Bone Joint Surg Am. 1993;76:13–9.
5.
Henley MB, Chapman A, J S, MF B, SK M, K.A. Comparasion of unreamed tibial nails and external fixators in treatment of grade II and III open tibial shaft fractures. Orthop Trans. 1995;19:438–9.
6.
Behrens F, Searls K. External fixation of the tibia. Ba sic concepts and prospective evalution. J Bone Joint Surg Am. 1986;68:246–54.
7.
Patzakis MJ, Harvey JP, Ivler D. The role of antibiotics in the management of open fractures. J Bone Joint Surg Am. 1974;56:532–41.
8.
Golubović Z, Mitković M, Maksimovic M. Retrospectiv analysis of postoperative infections frecvency after open fracture internal fixation tratment. Acta Orthop Iugosl. 1995;26(suppl 1):211–3.
9.
Kreder HJ, Armstrong P. A reviw of open tibial frac tures inshildren. J Pediatr Orthop. 1995;15:482–8.
10.
Kinsfater K, Jonassen EA. Ostomyelitis in grade II et III open tibia fractures with late debridman. J Orthop Trauma. 1995;9:121–7.
11.
Spencer J, Smith A, Woods D. The effect of time de lay on infection in open long bone fractures: a 5-year prospective audit from a distict general hospital. Ann R Coll Surg Engl. 2004;86:108–12.
12.
Gustilo RB, Mendoza RM, Williams DN. Problems in the management of type III (severe) open fractures. A new classification of type III open fractures. J Trauma. 1984;24:742–6.
13.
Chapman MW, Olson SA. Open fractures. In: Rockwood and Green’s fractures in adults Philadelpia Lippincott-Raven. 1996. p. 305–52.
Olson SA. Instructional Course Lectures, The Ameri can Academy of Orthopaedic Surgeons - Open Frac tures of the Tibial Shaft. Current Treatment J Bone Joint Surg Am. 1996;78:1428–37.
16.
Clancey GJ, Hansen ST. Open fractures of tibia. A rev iew of one nunred and two cases. J Bone Joint Surg Am. 1978;60:118–22.
17.
Edwards CC, Simmons SC, Browner BD, Weigel MC. Severe open fractures. Results treating 202 injuries with external fixation. Clin Orthop Relat Res. 1988;230:98–115.
18.
Mitković M, Bumbaširević M, Golubović Z, Micić I, Mladenović D, Milenković S, et al. New concept in external fixation. Acta Chir Iugosl. 2005;52(2):107–11.
19.
Mitković M. Spoljna fiksacija u traumatologiji. 1992.
20.
Okike K, Bhattacharyya T. Trends in the management of open fractures. A critical analysis. J Bone Joint Surg Am. 2006;86:2739–48.
21.
Court-Brown CM, McQueen MM, Quaba AA, Christie J. Locked intramedullary nailing of open tibial fractu res. J Bone Joint Surg Am. 1991;73:959–64.
22.
potkolenice BIP. U. 1998;39–46.
23.
Golubović Z. Lečenje zatvorenih preloma potkoleni ce. 1997.
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