External Transosseous Osteosynthesis in Treatment of Tibia Extraarticular Fracture: Indications, Complications, Results
Introduction. The choice of rational methods for osteosynthesis of tibia extraarticular fractures is still being discussed in scientific literature. The external blocking is commonly used in open fractures, high energy traumas, soft tissues lesions, especially in the lower third of tibia. It is not wide spread enough due to concerns about inflammatory complications and inconvenience for a patient. Aim of the study. To analyze the experience of external transosseous osteosynthesis in tibia extraarticular fractures and to ground indications for its usage. Materials and methods. The cases of 67 patients with tibia extraarticular fractures treated by the method of external blocking were analyzed. The complications and treatment results were studied. The indications for the application of this method were analyzed considering its benefits over inconveniences associated with the external module. Results. Non-united fractures were registered in 4 (5.9 %) patients, inflammatory complications were found in 2 (2.9 %) persons, ankle contractures — in 4 (5.9 %) patients. A good result was registered in 55 (80.9 %) patients, satisfactory outcome — in 8 (11.1 %), poor result — in 5 (7.3 %) persons. During the treatment the patients were mobile, were able to do activities of daily living, to axial load and joints movement. The analysis of the indications for external blocking showed that in some situations (fractures with traumatic and trophic lesions of soft tissues, tibia fractures type C, double (triple) fractures, tibia fracture as a part on multiple trauma, extraarticular fractures of both shins, treatment of non-united fractures and bones defects) benefits of external blocking are over inconveniences associated with external construction. Conclusions. Thus, external transosseous osteosynthesis is an effective method for the treatment of tibia extraarticular fractures. Concerns about high incidence of inflammatory complications and inconveniences associated with apparatus application using modern constructions are exaggerated. The recipe for this method effectiveness is usage of the constructions that allow axial load and joint movement, step-wise action on bone fragments, severe technology compliance.
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