مقایسه اکسترنال فیکساتور با اینتـرامدولاری نیلینگ در درمان شکستگی‌های باز تیبیا

Background and purpose: Ëxternal fixation is currently considered as a standard treatment for open tibial fractures however, due to the long-term hospitalization and some other complications, some researchers have proposed intramedullary nailing as the alternative surgical treatment. This study was conducted to compare the treatment of open tibial shaft fractures by external fixation and intramedullary nailing. Materials and methods: This randomized controlled clinical trial was conducted on 113 patients with open tibial fractures type Ï and ÏÏ (Gustilo classification) during a two year period. These patients were divided in two groups and 59 cases were operated using external fixation and 54 fractures were fixed with intramedullary nailing. The patients were compared for complications such as :::union::: time, delay in the :::union:::, non:::union::: and infection. Results: Ône hundred and thirteen patients (95 males and 18 females) with the age range of 18-50 years (average age: 34.3) were enrolled in this study. Âmong the 59 patients treated with external fixator, 8 had delayed :::union:::. Three of these eight patients suffered from the non:::union::: and did not have any progress in callus formation till 6 months after the treatment. Ôn the other hand, among the patients (54 cases) treated with intramedullary nailing, 2 cases suffered from the delayed :::union::: and one had non:::union:::. The difference between the two methods of treatment in delayed :::union::: and non:::union::: situation was not statistically significant (P>0.05). Çonclusion: Due to the reduced hospital stay in intramedullary method and the necessity of doing repeated surgery and applying intramedullary nailing when the patients are not treated with external fixation, the researchers recommend intramedullary nailing as the first option in treating such patients.