Seong Yeon Lim; Il Jae Lee; Jae Ho Joe; Hyung Keun Song

doi:10.12671/jkfs.2014.27.4.267

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Original Article
Treatment of Type IIIb Open Tibial Fractures: Seong Yeon Lim, M.D., Il Jae Lee, M.D., Jae Ho Joe, M.D., Hyung Keun Song, M.D.; Journal of the Korean Fracture Society 2014;27(4):267-273.
DOI: https://doi.org/10.12671/jkfs.2014.27.4.267
Published online: October 20, 2014

Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Korea.

^*Department of Plastic Surgery, Ajou University School of Medicine, Suwon, Korea.

Address reprint requests to: Hyung Keun Song, M.D. Department of Orthopedic Surgery, Ajou University Hospital, 164 WorldCup-ro, Yeongtong-gu, Suwon 443-380, Korea. Tel: 82-31-219-5220, Fax: 82-31-219-5229, ostrauma@ajou.ac.kr

• Received: April 4, 2014 • Revised: May 12, 2014 • Accepted: July 10, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
NOTES
REFERENCES

Abstract

Purpose
The purpose of this study is to evaluate the outcome of treatment for patients with Type IIIb open tibial fractures.
Materials and Methods
This study targeted 35 adult patients for whom follow-up was possible over one year after undergoing surgical treatment. There were 29 males and six females with an average age of 45 years.
Results
Fracture location was proximal in 10 cases, midshaft in 13 cases, and the distal part of the tibia in 12 cases. An average of 10 days was observed for definitive fixation with soft tissue coverage of the injury. The mean time to radiographic union was 27 weeks. Sixteen cases (45.7%) of complications were observed. Three cases of superficial infection, two cases of deep infection, four cases of partial flap necrosis, three cases of mal-alignment, three cases of joint stiffness, and one case of hardware breakage were observed. The mean lower extremity functional scale score was 68.5 and the factors influencing the clinical results were severity of open wound (p=0.000) and occurrence of complications (p=0.000) according to results of multiple regression analysis.
Conclusion
In treatment of Type IIIb open tibial fractures, good clinical results can be expected provided that complications are prevented through proper reduction, firm fixation, early soft tissue reconstruction, and early rehabilitation.
Key words: Tibia, Open fractures, Soft tissue injuries, Negative-pressure wound therapy

Financial support: None.

Conflict of interest: None.

REFERENCES

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Fig. 1

(A) A 65-year-old man sustained a type IIIb open tibia segmented fracture. (B) The vacuum-assisted closure system was applied to the open wound after debridement and temporary external fixation and provisional plate fixation. (C) An unreamed tibial nail was applied with an antero-lateral thigh free flap at 12 days after injury. (D) No visible callus on the proximal segmented area was observed at two months after surgery. (E) Plate augmentation without bone graft. (F) Clinical photograph shows a successful result 14 months after injury and the fracture was healed without complication.

Table 1

Factors associated with Complication Following Open Tibial Fractures

Values are presented as mean±standard deviation or number (%). ^*Mann-Whitney test, ^†Fisher's exact test, ^‡Chi-square test.

Table 2

Associations of Lower Extremity Functional Scale with Patient Variables

^*Time trauma to definitive surgery, ^†Used on definitive surgery (nail or plate).

Figure & Data

REFERENCES

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Effect of Korean Medicine Treatments in Patients with Proximal Tibia Fracture: A Retrospective Observational Study
Jung Min Lee, Eun-Jung Lee
Journal of Korean Medicine Rehabilitation.2020; 30(3): 141. CrossRef

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Treatment of Type IIIb Open Tibial Fractures

J Korean Fract Soc. 2014;27(4):267-273. Published online October 31, 2014

DOI: https://doi.org/10.12671/jkfs.2014.27.4.267

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Treatment of Type IIIb Open Tibial Fractures

Fig. 1 (A) A 65-year-old man sustained a type IIIb open tibia segmented fracture. (B) The vacuum-assisted closure system was applied to the open wound after debridement and temporary external fixation and provisional plate fixation. (C) An unreamed tibial nail was applied with an antero-lateral thigh free flap at 12 days after injury. (D) No visible callus on the proximal segmented area was observed at two months after surgery. (E) Plate augmentation without bone graft. (F) Clinical photograph shows a successful result 14 months after injury and the fracture was healed without complication.

Fig. 1

Treatment of Type IIIb Open Tibial Fractures

Table 1

Factors associated with Complication Following Open Tibial Fractures

Values are presented as mean±standard deviation or number (%). ^*Mann-Whitney test, ^†Fisher's exact test, ^‡Chi-square test.

Table 2

Associations of Lower Extremity Functional Scale with Patient Variables

^*Time trauma to definitive surgery, ^†Used on definitive surgery (nail or plate).

Table 1 Factors associated with Complication Following Open Tibial Fractures

Values are presented as mean±standard deviation or number (%). ^*Mann-Whitney test, ^†Fisher's exact test, ^‡Chi-square test.

Table 2 Associations of Lower Extremity Functional Scale with Patient Variables

^*Time trauma to definitive surgery, ^†Used on definitive surgery (nail or plate).