TREATMENT OF CLOSED TIBIAL SHAFT FRACTURES WITH UNILATERAL EXTERNAL FIXATION

Sixty-eight closed tibial shaft fractures were treated with an anterio r unilateral external Fixator over a 5 year period (1986-1991). Pin tr act drainage and/or infection was seen in 71/380 pins. The total numbe r of secondary operations, excluding planned pin extraction, during fr acture healing was 61 (including 22 due to pin tract problems and 25 s econdary corrections of alignment). Delayed union was seen in 14 fract ures and non-union in three. Healing disturbances were move frequent f ollowing high-energy trauma. Bone grafting was done in 11 fractures. E ventually all fractures healed within an average of 22 weeks. There we re three refractures. At follow-up, on average 3 years after injury, f unctional results were excellent in 41 per cent, good in 46 and accept able in 13 per cent. Due to the high number of unpinned secondary oper ations and prolonged healing times we do not consider the use of unila teral external fixation to be an adequate method : for the treatment o f closed tibial shaft fractures. The poor results are probably due to weight-bearing being too high in these patients relative to the mechan ical stability provided by the external Fixator system.