title: Do additional intramedullary elastic nails improve the results of definitive treatment with external fixation of open tibia fractures? A prospective comparative study.
abstract: OBJECTIVE
  External fixation has been associated with a high incidence of complications and poor outcomes due to the instability and difficulty in treating open tibia fractures. We use intramedullary (IM) elastic nails to supplement the external fixator. We compared the results of fractures treated by external fixation with and without IM-elastic nail.
  
  
  OBJECTIVE
  The combination of external fixation with IM-elastic nails may be used as an alternative to solve problems due to the external fixators alone in open tibia fractures.
  
  
  METHODS
  Group 1 included prospectively 26 cases (15 males and 11 females, mean age 37.5 ± 12.4 years) treated with external fixation and IM-elastic nails, whereas group 2 consisted of 28 cases (23 males and five females, mean age 30.7 ± 14.0 years) treated with standard external fixation. Functional and bone results were made using the criteria proposed by ASAMI.
  
  
  RESULTS
  The mean follow-up period was 3.96 ± 2.0 years in group 1 and 3.32 ± 2.1 years in group 2. The mean duration to external fixation and mean time to union were significantly lower in group 1 (P<0.001). In addition, bone and functional results were significantly higher in group 1 (P<0.01), however, pin track infections were lower in group 1 (P<0.01).
  
  
  CONCLUSIONS
  Our results showed the improvement in outcomes with IM-elastic nails: decreased duration of external fixation need and decreased bone healing delay. Therefore, this method may be a superior alternative for preventing complications related to external fixation in open tibia fractures.
  
  
  METHODS
  Level III: prospective comparative study.
authors: Department of Orthopaedics and Traumatology, Harran University School of Medicine, Yenisehir, 63100 Sanliurfa, Turkey. erturkc@yahoo.com
authors: C
authors: C
authors: Ertürk
authors: M A
authors: MA
authors: Altay
authors: A
authors: A
authors: Bilge
authors: N
authors: N
authors: Altay
authors: U E
authors: UE
authors: Işikan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001858:Bone Nails; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult