A Clinical Comparison between One-Plane Bilateral Frame and Two-Plane Bilateral Frame of External Fixation in the Treatment of Open Tibial Shaft Fractures

Treatment of open tibial shaft fracture is difficult, especially when there are severe soft tissue damage. Various complications are noted. The aims of treatment for the open fractures are to promote primary wound healing and union of the fractured bone. We have employed external skeletal fixation devices those are Hoffmann apparatus and pin & resin external fixator for the treatment of 34 cases of open tibial shaft fractures from March, 1981 to May, 1984. Each fixation method was divided into two type, one-plane bilateral frame (180' frame) and two-plane bilateral frame(120') Following results were obtained. 1. Open tibial shaft fracture was most commonly occured in age of high activity of male. 2. External fixation was very useful as a primary treatment method in open tibial shaft fracture. 3. The most common complication was pin tract infection. 4. Mean duration of fixation was 12.6 weeks. After removal of extemal fixation, 8 cases of delayed or nonunion were noted. In addition to bone graft, secondary open reduction and internal fixation with plate and screws (7 cases), only bone graft (1 case) were carried out. Good results were obtained. 5. There was no significant difference in bone union time between 180' frame and 120' frame. The complications were more frequently occured in 120' frame than in 180' frame.