title: Definitive Management of Open Tibia Fractures Using Limb Reconstruction System.
abstract: BACKGROUND
  Open fractures are treated as surgical emergency and early administration of intravenous antibiotic coupled with early irrigation and debridement decreases the infection rate dramatically. Limb Reconstruction System (LRS) is a unilateral rail system which consists of Shanz pins, rail rods and sliding clamps. It is specifically designed to enable the surgeon to perform simple and effective surgery as it offers rigid fixation of fracture fragments, allowing early weight bearing and reduces economic burden.
  
  
  OBJECTIVE
  To determine the efficacy of Limb Reconstruction System for treatment of compound tibia fractures.
  
  
  METHODS
  A prospective study was carried out where in 54 cases out of 412 compound tibia fractures having Modified Gustilo Anderson Type IIIA and IIIB with a mean age of 42±5 years were treated using LRS over a period of 26 months. Limb reconstruction system was used in acute docking mode or with corticotomy and bone transport was done depending upon the bone loss. The soft tissue condition was assessed and split thickness skin grafting and flap repairs were done as per the need. Clinical and radiological assessment was done at every follow-up. Bony and functional assessment was done by Association for the Study and Application of the Methods of Illizarov (ASAMI) criteria.
  
  
  RESULTS
  Among 54 patients, bony results as per ASAMI score were excellent in 36, good in 14, fair in 2 and poor in 2 patients. Functional results were excellent in 43, good in 7, fair in 4 patients. The average fracture union time was 8 months. Post-surgery patient satisfaction was excellent since fixation allowed weight bearing immediately. Average hospital stay was 7 days and financial burden was reduced by 40% as compared to multi staged surgery. The average time of return to work was 20 days.
  
  
  CONCLUSIONS
  LRS is an easy, simple and definitive surgical procedure that allows immediate full weight bearing walking. It reduces hospital stay, is cost effective with excellent patient compliance and can also be used for bone lengthening/transportation.
authors.affiliation: Professor, Department of Orthopaedics, Jawaharlal Nehru Medical College (Karnataka Lingayat Education University) and Dr. Prabhakar Kore Hospital and Medical Research Center , Nehru Nagar, Belagavi, Karnataka, India .
authors.forename: Mahantesh Yellangouda
authors.initials: MY
authors.lastname: Patil
authors.affiliation: Post Graduate, Department of Orthopaedics, Jawaharlal Nehru Medical College (Karnataka Lingayat Education University) and Dr. Prabhakar Kore Hospital and Medical Research Center , Nehru Nagar, Belagavi, Karnataka, India .
authors.forename: Srinath Myadam
authors.initials: SM
authors.lastname: Gupta
authors.affiliation: Post Graduate, Department of Orthopaedics, Jawaharlal Nehru Medical College (Karnataka Lingayat Education University) and Dr. Prabhakar Kore Hospital and Medical Research Center , Nehru Nagar, Belagavi, Karnataka, India .
authors.forename: Sri Krishna Chaitanya
authors.initials: SK
authors.lastname: Kurupati
authors.affiliation: Post Graduate, Department of Orthopaedics, Jawaharlal Nehru Medical College (Karnataka Lingayat Education University) and Dr. Prabhakar Kore Hospital and Medical Research Center , Nehru Nagar, Belagavi, Karnataka, India .
authors.forename: Saumya
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Post Graduate, Department of Orthopaedics, Jawaharlal Nehru Medical College (Karnataka Lingayat Education University) and Dr. Prabhakar Kore Hospital and Medical Research Center , Nehru Nagar, Belagavi, Karnataka, India .
authors.forename: Vishal
authors.initials: V
authors.lastname: Chandarana
keywords: Bone loss; Bone transport; Compound tibia fracture; Corticotomy; External fixator; Pin tract infection