Unilateral External Fixator Combined with Lateral Auxiliary Frame for Ultimate Treatment of Tibia and Fibula Shaft Fractures with Poor Soft Tissue Conditions

Abstract

Background. For severe soft tissue damage or open fracture, unilateral external fixation is one of the treatment choices. In the current study, a unilateral external fixator combined with a lateral auxiliary frame was used to treat tibia and fibula shaft fractures with poor soft tissue conditions to verify its feasibility for the ultimate treatment. Methods. We retrospectively analyzed the patients with tibia and fibula shaft fractures who underwent unilateral external fixator combined with lateral auxiliary frame between December 2018 and October 2020. The clinical outcomes were recorded. Results. 31 patients with tibia and fibula shaft fractures who received unilateral external fixator combined with lateral auxiliary frame were included in the current study. Among them, 23 cases had closed fractures with poor soft tissue and 8 cases had Gastilo type I open fractures. The average duration of hospital stay was $7.3\pm 2.3$ days. The causes of injury were traffic accidents in 15 cases (48.4%), fall from height in 7 cases (22.6%), crush injury in 5 cases (16.1%), and other causes in 4 cases (12.9%). During follow-up, the clinical healing time was $3.0\pm 0.85$ months. Additionally, the infection rate of pin-tract and reoperation rate was 12.9% and 3.2%. Fortunately, all patients achieved fracture healing and recovered well without joint dysfunction and obvious claudication. The Johner-Wruh scores showed that 27 cases (87.1%) were “excellent” and 4 cases (12.9%) were “good.” Conclusions. The unilateral external fixator combined with lateral auxiliary frame is an effective option for ultimate treatment of the tibia and fibula shaft fractures with poor soft tissue conditions.