Early Outcome of Treatment of Open Tibial Shaft Fractures Using External Fixators in Resource-Poor Setting
To document the outcome of treatment in the first six months for open tibial shaft fractures managed with external fixators in resource-poor
economy and the pattern of presentation of open tibial shaft fractures, a 12-month prospective observational study was conducted from January
2010 to December 2010. All the patients were recruited from the accident and emergency department of the University of Calabar Teaching
Hospital. The demographic data of each patient, the type of injury, the mechanism of injury, and the outcomes were assessed. Moreover, 42 patients
with open tibial shaft fracture were recruited for this study with forty (95.2%) patients successfully followed up for six months while two patients
(4.8%) were lost to follow-up. Their ages ranged from 18 to 65 years with a mean age 6 standard deviation of 33.5 6 12.8 years. Majority of the
patients (77.5%) were aged 20-50 years. There was a male to female ratio of 3:1. A total of 7 (17.5%) fractures healed after 20 weeks, Type IIIB
fractures were 3 (7.5%), Type IIIA fractures were 4 (10%), but all Type II fractures had united between 12 and 15 weeks. The middle third fractures 9
(22.5%) had the highest number of fracture union within 16-20 weeks. The major cause of the injuries was from motorcycle accidents, which were
30 (75%), and others were from cars 7 (17.5%) and buses 3 (7.5%). This was largely due to the utilization of motorcycles as the major means of
commercial transportation in the city until it was banned recently. However, they are still in use in the suburbs. The higher the Gustillo and Anderson
grading of the open fracture of tibia, the more severe the wound and bone infection that occurred, and a significant interval between the injury time,
wound debridement, and the time the external fixator was applied showed poor outcome for those who presented late (after two weeks of injury).
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