ACTA FAC MED NAISS 2011;28(4):251-256

Case report

UDC:616.718-001.5-089

 

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

 

Ivan Golubović1, Zoran Golubović1,3, Aleksandar Višnjić2,3, Stevo Najman3, Nenad Ilić4, Goran Đorđević4, Nebojša Krstić5, Milan Grubor6

1Orthopeadics and Traumatology Clinic, Clinical Center Niš, Serbia

2Public Health Institute Niš, Serbia

3University of Niš, Faculty of Medicine, Serbia

4Surgery Clinic, Clinical Center Niš, Serbia

5Clinic of Internal Medicine, Clinical Center Niš, Serbia

6Orthopeadics and Traumatology Clinic Banja Luka, Bosnia and Herzegovina


summary

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.

 

Key words: external skeletal fixator “Mitković”, reduction of dislocation, open tibial shaft fracture