The Effects of IESN and External Fixation in the Treatment of Open Tibial Fractures

Objective To evaluate the effects of Intramedullary Expand self-locking Nail(IESN) and External Fixator in the treatment of open tibia fractures.Methods From October 2000 to September 2003,32 cases with open tibial fractures were treated with IESN.A comparison was made between 32 cases of IESN and 30 cases fixed by external fixation.Results All patients were followed up from 12 to 18 months with an average of 16.2 months.The mean operative time was 50 min in IESN group and 63 min in external fixation group.The postoperative fever time of patients in IESN group subsided averagely 2.8 days,and 3.9 days in external fixation group.The mean hospitalization were 20 days in IESN group,and 26 days in external fixation group.The average clinical healing time of the fractures in IESN group were 10.5 weeks,and 12.9 weeks in external fixation group(t value 2.907、 2.848、 2.794、 2.832,P0.01),No delayed union or malunion,and no inflammation or internal fixation failure happened in IESN group.However,7 cases of inflammation and 6 cases of malunion occurred in external fixation group.Conclusion Intramedullary expand self-locking nail was an optimal approach to treat open tibial fractures.It was firm,with better healing rate and lower complication rate,and the blood supply of bone frame had been protected.According with the principle of biology fixation,it is an effective treatment to open tibial fractures.