Primary external fixation and secondary intramedullary nailing in the treatment of tibial fractures

Wheelwright, E.F.; Court-Brown, C. M.

doi:10.1016/0020-1383(92)90010-p

Cited by 42 publications

(31 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Functional outcome was good to excellent in all their cases. In our study non-union rate 6.7% which is relatively lower than many series, Wheelwright et al [20] showed that if secondary nailing is delayed until after granulation of the pin sites the technique would be associated with a low infection rate. They reported union rate 11.6% and 7% infection rat.…”

Section: No Paincontrasting

confidence: 52%

Staged Procedures after Failing Ring Fixators of Lower Limb? Series of 15 Cases Abstract

Kornah¹,

Safwat²,

Sultan³

et al. 2016

J Trauma Treat

View full text Add to dashboard Cite

Background: Failure of the fixators is a challenging, especially in the presence of osteoporosis, bone defect, pin track infection and joint stiffness. This study aims at evaluating the functional outcomes of the lower limb proposed two-stage management of non-union after failed ring external fixation.Patients and Methods: 15 patients (six females) with age range 22-65 years enrolled in this study. Four had femoral fractures and eleven with tibial fractures. All were due to high-energy trauma and all were open ones (3 grade (I), 8 grade (II) and 4 grade (III)). Categorised AO classification, 5 type (A), 4 type (B) and 6 type (C). They initially treated by ring external fixators and had radiological signs of non-union. Treatment involved removal of external fixators, pin track and blood tests until no active infection. Non-union managed by refreshing the fracture ends, opening the medullary canal, packing the non-union with autogenous bone grafts then realigning the fracture properly and stabilizing it with locked plate or interlocking nail.Results: Average duration of nonunion 9.8 months. Average delay prior to osteosynthesis after removal of external fixation 15 days. All non-unions healed on an average 5.2 months. According to the Karlstrom-Olerud scores, final functional outcome score was excellent 7cases, good 5 cases, accepted 2 cases and poor one case.Conclusions: Two-stage treatment of non-union of long bone after ring fixation is an effective tool and may be a favorable option with low risk of complications and a high level of functional outcomes.

show abstract

Section: No Paincontrasting

confidence: 52%

Staged Procedures after Failing Ring Fixators of Lower Limb? Series of 15 Cases Abstract

Kornah¹,

Safwat²,

Sultan³

et al. 2016

J Trauma Treat

View full text Add to dashboard Cite

show abstract

“…Musculoskeletal trauma is often complicated by a high risk for ischemia/reperfusion injuries and secondary infections and the risk increases with the degree of soft tissue injury and fracture wound contamination. Although favorable result have been reported when secondary nailing is delayed until after granulation of the pin sites,32 recent clinical studies indicate a significant increase of this risk in late conversion procedures, that is, after 28 days 6…”

Section: Discussionmentioning

confidence: 99%

The Effect of timing of conversion from external fixation to secondary intramedullary nailing in experimental tibial fractures

Sigurdsen

Reikerås

Utvåg

2010

Journal Orthopaedic Research

View full text Add to dashboard Cite

Diaphyseal tibial fractures with initial temporary external fixation (EF) are usually converted to intramedullary nailing (IMN) within 2 weeks, and no consensus on the optimal conversion time point exists. Current clinical practice is mainly based on estimation of the risk of postoperative infection. This is the first investigation of the effect of timing of such conversion on fracture healing. Forty male rats received a standardized tibial shaft osteotomy and EF. The animals were then randomly assigned to conversion to IMN at either 7 (group A, N = 10), 14 (group B, N = 10), or 30 (group C, N = 10) days after initial fixation. Group D (N = 10) served as a control group without conversion. Evaluation at 60 days included X-ray, DXA, and mechanical testing. Group A had significantly increased bone mineral content and callus area compared to the control group. Groups B and C showed significantly inferior mechanical bending strength and rigidity compared to both group A and the control group (D). The timing of the conversion procedure has a significant effect on fracture healing. Early conversion procedure did not improve healing compared to control, but was advantageous compared to late conversion (at 2 or 4 weeks) with higher mineralization and superior biomechanical properties.

show abstract

“…De nombreux auteurs comme Wheelwright et Court Brown [24], Blachut et al [14] réalisent l'enclouage uniquement après le bourgeonnement des orifices de fiches (délai minimal de 9 jours). La procédure en deux temps présente l'avantage théorique de la cicatrisation cutanée des orifices de fiches.…”

Section: Discussionunclassified

Enclouage différé secondaire après fixateur externe des fractures diaphysaires tibiales : facteurs de risque relatifs à la consolidation et l’infection. Une série de 55 cas

Roussignol

Sigonney

Potage

et al. 2015

Revue de Chirurgie Orthopédique et Traumatologique

View full text Add to dashboard Cite

Primary external fixation and secondary intramedullary nailing in the treatment of tibial fractures

Cited by 42 publications

References 16 publications

Staged Procedures after Failing Ring Fixators of Lower Limb? Series of 15 Cases Abstract

Staged Procedures after Failing Ring Fixators of Lower Limb? Series of 15 Cases Abstract

The Effect of timing of conversion from external fixation to secondary intramedullary nailing in experimental tibial fractures

Enclouage différé secondaire après fixateur externe des fractures diaphysaires tibiales : facteurs de risque relatifs à la consolidation et l’infection. Une série de 55 cas

Contact Info

Product

Resources

About