External fixation and secondary intramedullary nailing of open tibial fractures. A randomised, prospective trial.
- 1 May 1997
- journal article
- clinical trial
- Published by British Editorial Society of Bone & Joint Surgery in The Journal of Bone and Joint Surgery. British volume
- Vol. 79 (3) , 433-437
- https://doi.org/10.1302/0301-620x.79b3.7394
Abstract
We 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.Keywords
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