Short-term results of grade III open tibia fractures treated with circular fixators

Abstract

Grade III open tibia fractures have previously been shown to have high infection and non-union rates, and the optimal treatment remains controversial. We present the short-term results of 94 consecutive Gustilo-Anderson grade III open tibia fractures, definitively treated with circular external fixators in this retrospective study. A total of 94 patients (80 males and 14 females), with a mean age of 36.5 years (range 8-73) were followed up for a mean period of 12 months (range 6-52). Deep infection occurred in four patients (4.3%) and non-union in three patients (3.2%). The mean time to union was 23 weeks (range 11-79). The prevalence of HIV infection was 32.9% and no statistically significant association between HIV infection and an increased risk of deep infection (p = 0.601) or nonunion (p = 0.577) could be demonstrated. Pin-site infection occurred in 16% with the majority being low-grade infections. The management of grade III open tibia fractures with definitive circular external fixation delivered promising short-term results with low complication rates in terms of infection and non-union.