Treatment of Open Tibial Fractures: Converting or Continuing External Fixation?

Background: the treatment of open tibial fractures is still anorthopaedic cha llenge and full of compl icat ions. in manycases the use of external fixator that has been known as a nonunionmachine is obligatory with a high incidence of pin trackinfection and other complicat ions. the aim of this study wasto compare the use of extern al fi xation as a definite methodfor treatment of open tibial fracture s with its subsequent conversion to internal fixation or casting.methods: sixty-seven young patients with type iii open tibialfractures (gusti lo-a nderson classification) were treated with halfpin external fixation. twenty of them were convert ed into internalfi xation after a period of 6-8 weeks. for another twenty-fi ve.external fixator was removed and treatment continued with castingfor a period lasting from 16 to 20 weeks. and for twenty twopatients the fixator continued until complete union. the patientsfollowed up for 10-16 months and were evaluated in terms ofunion time, union rate, infection, range of motion, malunion,non-union, nerve injury, and reduction.results: there was a meaningful difference only in the uniontime and superficial infection between the first grou p and theother two groups.conclusion: the conversion of external to internal fixation canbe considered as a safe, effec tive, jess complicated, and moreacce ptable method for the treatment of open tibial fractu res.