title: [Use of an external fixator in open tibial shaft fractures as definitive treatment].
abstract: BACKGROUND
  We conducted a study evaluating the clinical and radiologic results of the open tibial shaft fractures using an external fixator as definitive treatment.
  
  
  METHODS
  Clinical, observational, descriptive, prospective and longitudinal study. Forty-six patients were included, 40 males (87%) and 6 females (13%), whose age was 31.02 +/- 14.62 years; the time elapsed from the accident to admission in the Emergency Room was 1-16 hours, with a mean of 5.1 +/- 3.35 hours. Ten patients (21.74%) had a Gustilo grade I open fracture, and 36 patients (78.26%) a Gustilo grade II fracture. They were also classified according to the AO classification, with the following resulting groups: 13 (28.9%) patients were A3, 12 (26.1%) were B3, 8 (17.4%) B1, 8 (17.4%) were B2, and 5 (10.9%) were A2. The dynamization of the fixator was done at a mean of 11.56 +/- 1.10 weeks.
  
  
  RESULTS
  Forty-three patients had healing at 23.51 +/- 3.62 weeks; Gustilo I fractures healed at 22.8 +/- 3.5 weeks; Gustilo II fractures at 23.7 +/- 3.7 weeks, with a P value of 0.48. In 3 patients (6.53%), due to absence of healing, the external fixator was exchanged for an intramedullary nail with a bone graft, with healing occurring at 18 weeks. Six infections (13%) were reported at the nail insertion site; angulations ranged from 0 degrees to 8 degrees, which is tolerable.
  
  
  CONCLUSIONS
  This fixator is safe in properly selected patients, since the few complications that occurred are similar to other reports using different internal fixation methods.
authors.affiliation: Ortopedia y Traumatología IV, Hospital General Dr. Miguel Silva Morelia, Michoacán. drluispatio@yahoo.com.mx
authors.forename: L A
authors.initials: LA
authors.lastname: Patiño-Domínguez
authors.forename: R
authors.initials: R
authors.lastname: Reyes-Pantoja
authors.forename: J A
authors.initials: JA
authors.lastname: Silva-Méndez
authors.forename: J M
authors.initials: JM
authors.lastname: Vargas-Espinosa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016267:External Fixators; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods*; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult