title: Grade 3 open tibial shaft fractures treated with a circular frame, functional outcome and systematic review of literature.
abstract: We report on the surgical and functional outcome of 22 patients with Grade 3 open tibial fractures treated with circular frame. All cases united and there were no re-fractures or amputations. All patients were assessed at a minimum of 1-year post frame removal. Assessment included clinical examination, IOWA ankle and knee scores, Olerud and Molander ankle score and EuroQol EQ-5D. Clinical scores were either good or excellent in over half of the patients in all knee and ankle scores. There was a significant positive correlation between functional outcomes and the EQ-5D score. The EQ-5D mean health state visual analogue score was comparable to the general UK population despite patients scoring less than the average UK population in three of the five domains. 36% reported some difficulties in walking and 41% had problems with pain. 14% had difficulties with self-care and 46% had difficulties with their usual activities. 14% had problems with anxiety or depression. Systematic review of the literature suggests, in the management of open tibial fractures, circular frames provide equivalent or superior surgical outcomes in comparison with other techniques. Our study finds the application of a circular frame also results in a good functional outcome in the majority of cases.
authors: Hull Royal Infirmary, Anlaby Road, Hull HU3 2JX, United Kingdom. Electronic address: davidrdickson@hotmail.com.
authors: D R
authors: DR
authors: Dickson
authors: Hull Royal Infirmary, Anlaby Road, Hull HU3 2JX, United Kingdom.
authors: E
authors: E
authors: Moulder
authors: Hull Royal Infirmary, Anlaby Road, Hull HU3 2JX, United Kingdom.
authors: Y
authors: Y
authors: Hadland
authors: Leeds General Infirmary, Great George Street, Leeds LS1 3EX, United Kingdom.
authors: P V
authors: PV
authors: Giannoudis
authors: Hull Royal Infirmary, Anlaby Road, Hull HU3 2JX, United Kingdom.
authors: H K
authors: HK
authors: Sharma
mesh_terms: D001007:Anxiety; D003863:Depression; D017102:Fracture Healing; D005597:Fractures, Open / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique; D010146:Pain / Q000503:physiopathology / Q000523:psychology*; D010147:Pain Measurement; D020127:Recovery of Function; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data*; D013978:Tibial Fractures / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Frame; Functional outcome; Ilizarov; Open fracture; Systematic review; Tibia