Treatment of grade 3a and 3b compound tibial fractures with external fixation and primary immediate bone grafting

Introduction- The present study report results of a series of type 3A and 3B open fractures treated with debridement and fracture fixation and immediate bone grafting. Methods- Twenty one patients were treated from January 2017 to January 2018. All fractures were treated with a modular external fixator. Nine fractures were type 3A and 12 were type 3B. All fractures received debridement, external fixation, bone grafting and flap or skin graft coverage. All fractures were analyzed for time to fracture union, incidence of pin tract infection, incidence of wound infection, flap complications, and delayed or non union. Results- After a mean follow up period of 14 months (range 12 to 16 months), it was concluded that the time to fracture union was 22 weeks, and all fixators were removed only after radiological evidence of fracture union. 1 (5%) patients developed deep wound infection, one experienced delayed union. Conclusion- Along with early wound coverage and external fixation, primary bone grafting can be employed in grade 3 open fractures of tibia with good results and without any increased risk of wound complications