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Correction of Secondary Dislocation of Open Tibial Shaft Fracture after External Fixation-Case Report

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Author(s): Ivan Golubović | Zoran Golubović | Aleksandar Višnjić | Stevo Najman | Nenad Ilić | Goran Đorđević | Nebojša Krstić | Milan Grubor

Journal: Acta Facultatis Medicae Naissensis
ISSN 0351-6083

Volume: 28;
Issue: 4;
Start page: 251;
Date: 2011;
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Keywords: external skeletal fixator “Mitković” | reduction of dislocation | open tibial shaft fracture

ABSTRACT
Open tibial shaft fractures rank as the most common fractures of the locomotor system. External skeletal fixation, after primary open fracture wound management, stands for a good method in the management of open tibial shaft fractures, as it does not poses an additional threat to the bone vascularisation in the fracture area, which is important for wound healing and reduction of deep infection occurrence percentage. The paper presents a nine-teen-year-old patient who sustained an open right tibial shaft fracture in a motorcycle accident when he ran into a car. After performing an x-ray examination and short preoperative preparation, we proceeded to primary open fracture wound management, bloody reposition of tibial fragments and external fixation by unilateral external skeletal fixator with convergent pin orientation. Early postoperative course was uneventful. Twenty days following the external fixation, the patient fell while getting out of the car, when his crutch stuck in the metal fence. On control x-ray examination, a dislocation of tibial fragments was seen at the fracture site. After the administration of appropriate analgesic therapy and loosening the external fixator clamps, a correction of fracture dislocation was performed. On control x-ray examination, a good position of fragments after correction was observed. The unilateral external skeletal fixator “Mitković” produced by “Trafix” firm enables a simple correction of fracture dislocation, without performing additional surgical procedures.

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