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J Bone Joint Surg Br · May 1997
Randomized Controlled Trial Comparative Study Clinical TrialExternal fixation and secondary intramedullary nailing of open tibial fractures. A randomised, prospective trial.
- P Antich-Adrover, D Martí-Garin, J Murias-Alvarez, and C Puente-Alonso.
- Department of Trauma and Orthopaedic Surgery, Hospital de Sabadell, Barcelona, Spain.
- J Bone Joint Surg Br. 1997 May 1; 79 (3): 433-7.
AbstractWe performed a prospective, randomised trial in 39 patients with open tibial fractures treated initially by external fixation to compare cast immobilisation (group A) and intramedullary nailing (group B) as a sequential protocol planned from the onset of treatment. The results showed that group B achieved faster union (p < 0.05) than group A with less malunion or shortening and a greater range of movement. Patients treated by intramedullary nailing required fewer radiographs and outpatient visits (p = 0.0015) and had a more predictable and rapid return to full function. We feel that these severe fractures are better treated by delayed intramedullary nailing and that this has an acceptable rate of complications.
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