Treatment of 103 displaced tibial diaphyseal fractures with a radiolucent unilateral external fixator

• Published in: Archives of orthopaedic and trauma surgery 2010-11, Vol.130 (11), p.1377-1382
• Main Authors: Dall’Oca, C., Christodoulidis, A., Bortolazzi, R., Bartolozzi, P., Lavini, F.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Diaphyses - injuries; External Fixators; Female; Fracture Fixation - instrumentation; Fractures, Closed - diagnostic imaging; Fractures, Closed - surgery; Fractures, Open - diagnostic imaging; Fractures, Open - surgery; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Orthopedics; Radiography; Tibial Fractures - diagnostic imaging; Tibial Fractures - surgery; Trauma Surgery; Young Adult
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s00402-010-1090-7

Objective The authors report their experience in the treatment of the diaphyseal tibial fractures, using the unilateral radiolucent External Fixator (EF) XCaliber. Design A total of 100 patients (average age 35 years, range 16–76) with 103 displaced diaphyseal tibial fractures were treated with the XCaliber. There were 59 type A fractures, 35 type B, and 9 type C (according to the AO classification) and 35 were open fractures. Main outcome measurements During the last assessment, patients were evaluated for level of pain, ability to perform weight-bearing activities, and number of residual deformities. Results The average follow-up time was 24 months, 3 patients (4 fractures) were excluded for final assessment and 1 patient moved abroad. Of the remaining 98 fractures, 83 (84.7%) healed with a single operation in a mean 21 weeks (SD 3.97; 12–38 weeks), 10 fractures had a delayed union and 5 fractures proceeded to a non-union. There were 13 complications. Among them, a loss of reduction was observed in 3 cases due to overload of the EF, in 3 cases, deep pin track infections were observed and 2 fractures healed with more than 1 cm of shortening. Conclusions The results are encouraging, since both complex and open fractures were included in this study. The XCaliber was shown to be a valid unilateral external fixator, combining the advantage of radiolucency during application and radioscopic follow-up with a stable and flexible fracture fixation. This represents the first report in the literature specifically examining treatment of tibial diaphyseal fractures with a radiolucent external fixator.