The role of supplemental lag-screw fixation for open fractures of the tibial shaft treated with external fixation.
Ninety-nine open fractures of the tibial shaft were treated with unilateral external fixation with or without supplemental lag-screw fixation. We compared the results in forty-four fractures in which only external fixation was used (control group) with those in fifty-five fractures that were stabilized with lag-screws and external fixation, and we found no statistically significant differences between the two groups with respect to the time to full weight-bearing, the time to union, or the rates of delayed union, osteomyelitis, malunion, superficial or deep pin-track infection, or loosening of the pins. The limbs in which the fracture was treated with external fixation and supplemental lag-screws had more than twice the rate of refracture of the control limbs (11 compared with 5 per cent), and the percentage of fractures having supplemental lag-screw fixation that needed bone-grafting to achieve union was more than twice that in the group treated with external fixation alone. We concluded that the routine use of supplemental lag-screw fixation is not indicated in patients who have an open fracture of the tibial shaft that has been stabilized with external fixation.
Krettek
C
C
Trauma Department, Hannover Medical School, Federal Republic of Germany.
Haas
N
N
Tscherne
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D016267:External Fixators; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery*