An Evaluation of the use of External Fixator in the Management of Open Tibial Shaft Fractures at a Tertiary Hospital in Pretoria, South Africa

Lower limb fractures result in a greater physical impact on health than those in other parts of the body. Open tibial fractures are orthopaedic emergencies necessitating prompt treatment. A study was conducted to determine the clinical profiles and outcomes of patients treated for open tibial fractures using the external fixator method.

We conducted a retrospective cohort study on 101 patients who had been treated with the external fixator method for open tibial fractures from 1^st January, 2014 to 31^st December, 2015. Patient profiles included their baseline characteristics, risk factors, and injury mode. Clinical outcomes were sepsis, delayed union, and the number of days to the union. Correlation tests were conducted to establish associations. All statistical tests were performed on SAS, Release 9.3 (2015). Statistical significance was set at p ≤ 0.05.

Most respondents were male (87; 86.1%) with a secondary level of education (83; 82.2%). The most frequent modes of injury were motor-vehicle accidents (MVAs) (34; 33.7%) and assault (21; 20.8%). MVA (27; 26.7%) resulted in the highest complications. Osteomyelitis and pin traction sepsis accounted for 19/65 (29%) of all complications. Delayed union was mostly observed among respondents who smoked cigarettes, i.e., 49/63 (29%).

MVA, PVA, gunshot, and assault constituted the highest proportions. Cigarette smoking was the risk factor with the highest proportion and was related to delayed union and non-union. Osteomyelitis and pin tract sepsis occurred in high proportions. Behavioural change towards quitting smoking and antibiotic coverage should be advocated to benefit patients with open tibial fractures.