OPEN TIBIAL FRACTURES TREATED WITH THE EX-FI-RE EXTERNAL FIXATION SYSTEM

Fifty open tibial shaft fractures were treated with the Ex-ii-re exter nal fixation system from 1987 to 1994, According to the Gustilo and An derson classification, there were 12 Grade I, 14 Grade II, 10 Grade II IA, 13 Grade IIIB, and 1 Grade IIIC injuries, Eight fractures were seg mental, The average patient age was 39 years (range, 16-85 years), Wit h the reduction unit of the system, displaced tibial fractures could b e reduced by the functions of the device in contrast to the manual red uctions needed with other unilateral devices, Compression could be app lied even to oblique fractures, The reductions were performed by this unit in all cases and were classified as exact in 28 of 41 cases, Exac t reduction was defined as a reduction in which there was no more than 2 mm of translational displacement, The 8 segmental fractures were no t classified according to reduction, Forty-three fractures healed with no secondary procedure, Three secondary bone graftings, 4 fibulotomie s, and 3 reamed intramedullary fixations were performed in 6 patients, Thirty-two skin grafts were performed, There was 1 fracture site infe ction, and 1 curettage and 1 sequestrectomy were performed after union , At 1 year followup there were no signs of infection, Median time to union was 20 weeks, and median time to full unprotected weightbearing was 22 weeks, Fractures with an exact reduction had a median time to u nion of 19 weeks, compared with a median of 31 weeks in reductions wit h greater than 2 mm translational displacement, The exact reduction an d translational compression applied in oblique fractures appeared to c ontribute to early consolidation.