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

Objective To evaluate the therapeutic effects of intramedullary expanding self-locking NaiI (IESN) and External Fixer on open tibial fractures.Methods From October, 2003 to September, 2005, 41 cases with open tibial fractures were treated with IBSN. A comparison was made between them and another 38 eases fixed by external fixation. Results All the patients were followed up from 12 to 20 months with an average of 15.4 months. The mean operative time was 45 min in the IESN group and 63 min in the external fixation group. The mean postoperative fever duration was 2.3 d in the IESN group and 3.2 d in the external fixation group. The mean hospitaIization was 2I d in the IESN group and 27 d in the external fixation group. The average clinical healing time of the fractures was 9.5 weeks in the IESN group and 13.2 weeks in the external fixation group (t=2.775, 2.712, 2.874, and 2.869; P0.01). No delayed union or malunion, and no inflammation or internal fixation failure happened in the IESN group. However, nine cases of inflammation and seven cases of malunion occurred in the external fixation group. Conclusion IESN acts as an optional approach to treat open tibial fractures with firm fixation, higher healing rate and lower complication rate, and the blood supply of bone frame is well protected. According with the principle of biological fixation, it is an effective treatment to open tibial fracture.