1. Abbas Memon 2. Mehtab Pirwani 3. Shakeel Ahmed Memon

1. Asstt. Prof. of Orthopaedic, 2. Asstt. Prof. of Orthopaedic, 3. Consultant Orthopaedic surgeon,  Liaquat University Hospital, Jamshoro, Hyderabad

ABSTRACT

Objective: To evaluate the comparative results of open diaphseal tibial fractures treated with A.O fixation and N.A fixation.

Study Design: Comparative and experimental study

Place and Duration of Study: This study was carried out at Orthopedic Department of Liaquat University Hospital Hyderabad from February 2011 to January 2013.

Materials and Methods: Total 50 cases were included in this study.  All the cases with diabetic mellitus and associated head and abdominal injuries were excluded from the study. All the cases were divided in two groups equally 25 patients in group A, treated by N.A fixator and 25 patients treated with A.O fixator were selected in group B.  Initial resuscitation, splintage and primary care for the wound was provided in the emergency department, any bone fragments that were protruding out were covered with sterile dressing. After counseling the patient and attendants regarding the condition of injury, its importance & possible complications, also explained about the method of treatment selected (Group A or Group B) then the patients were taken to the operating room. 

Results: The mean age + SD in group A (NAEF, n = 25) was 35.4 + 9.22 years and 32.10 + 9.69 years in groups B (AOEF, n = 25), Out of total cases, male were in majority. Majority of patients were found RTA in both groups.  In the group A (NAEF), pin tract infection 5(20.0%)  cases, pin site osteolysis 5(20.0%), pin loosening 5(20.0%) , pin site inflammation were in 3(12.0%) cases, which were cured by curettage of the outer cortex and oral antibiotics for a short period, 1(4.0%) patient went in infective nonunion and converted into Illizarrov external fixator.  Knee stiffness was found in 2(8.0%) and Ankle stiffness was 3(12.0%) cases, in group A (NAEF) and 3(12.0%) in group B.  Five (20.0%) patients of group A (NAEF) had mild limitation of ankle motion (mainly dorsiflexion) and 3(12.0%)  were with Limited Flexion,  patients of group B were without limitation of knee motion with a flexion ranges of 5(20.0%). 

Conclusion:  AO external fixator is much better than Naseer Awais External Fixator. It is simple and safe to apply, cost effective and successful management of open tibial fractures.

Key Words: Open Diaphyseal Tibial Fracture, A.O fixation vs N.A fixation