Frequency of Infection After Immediate Intramedullary Nailing Versus External Fixator in Open Tibial Shaft Fractures

Abstract

Objective: The purpose of this study was to have a comparison of frequency of infection between two procedures i.e immediate intramedullary nailing and external fixation in the treatment of type II open fracture of shaft of tibia. Study Design: The study design was a randomized controlled trial. Place and Duration of Study: The study was done at the Department of Orthopedic Surgery, Sir Ganga Ram Hospital Lahore over 1-year period from January 2017 through December 2017. Methodology: This included 40 patients of both genders aged between 19-51 years with type II (Gustilo and Anderson) open fracture of shaft of tibia. These patients were randomly divided in two groups with draw methods with A&B Groups. The patients who were put in group A were treated with External fixator with two half pins on either side of the fracture and patients with Group B allocation were treated with intramedullary nailing. The Frequency of infection was noted and compared between two groups in first 4 weeks after injury. Before including each patient in study a written informed consent was taken. Results: The age of the patients ranged from 19 years to 51 years. There were 32 (80.0%) male and 8 (20.0%) female patients in the study cohort with a male to female ratio of 4:1. Infection was observed in 3 (7.5%) patients. The frequency of infection with IM nail was lower than that of external fixator (5.0% vs. 10.0%; p=0.759). Similar insignificant difference was observed across various age and gender groups. Conclusion: Frequency of infection was lower in intramedullary nailing group as compared to external fixation group so immediate intramedullary nailing is preferred method in type II open tibial fractures.