Functional and radiological outcome in management of compound tibia diaphyseal fracture with AO monolateral fixator versus Limb reconstruction system.

INTRODUCTION: Tibia being the most common fractured long bone represents 36.7% of all long bone fractures in adults with open fracture comprises 23.5% of all tibial shaft fracture. The lack of the muscular covering over anteromedial aspect of the tibia and poor blood supply predispose open tibial fractures to a 10-20 fold increased risk of developing infection than open fracture in any other anatomical areas and a nonunion rate as high as 28% has been reported in the literature.

METHODS: We did a prospective study at our institute from 2014-2016 comprising 40 patients with compound tibia diaphyseal fracture managed with AO monolateral external fixator (Group 1) (n = 20) and Limb reconstruction system (Group 2) (n = 20) as primary and definitive tool. Final assessment for bone results and functional results were done using ASAMI (Association of the study and application of the method of Ilizarov) score.

RESULTS: In our study bony outcome by ASAMI score shows 6 (30%) patients had Excellent, 5 (25%) patients had Good and 9 (45%) had Poor bony outcome from Group I. In group II, 12 (60%) patients had Excellent, 4 (20%) patients had Good, 2 (10%) patients had Fair, and 2 (10%) had Poor bony outcome. The functional outcome by ASAMI score shows 3 (15%) patients had Excellent, 8 (40%) patients had Good, 5 (25%) patients had Fair, 3 (15%) had Poor bony outcome from Group I. In group II, 9 (45%) patients had Excellent, 7 (35%) patients had Good, 2 (10%) patients had Fair, and 2 (10%) had Poor functional outcome.

CONCLUSION: Limb reconstruction system (LRS) offers several advantage over AO monolateral external fixator such as ease of application, versatility, stronger fixation, less fixator related complications, early weight bearing and early bony union for management of compound tibia diaphyseal fracture as primary and definitive tool.