Single-frame External Fixator For Tibiofibular Fractures In Children

ObjectiveTo study the application and treatment of the complications of tibiofibular fractures in children with single-frame external fixator, improve our knowledge of the treatment of tibiofibular fractures.MethodsA retrospective investigation was analysed of 39 children with tibiofibular fractures who had been treated with Orthofix single—frame external fixator from March 2006 to February 2010 in our hospital, including 29 case of male and 10 case of female. The mean age of all patients was 6.5yr(range 2yr~14yr). All the patients were accompanied by soft tissue obviously swollen at the site of the fracture, including 21 cases of serious injury of soft tissue (54.8% of the total number). 2 cases of patient's condition was Severe. According to the fracture morphology, all of them were divided into 4 types, including transverse fracture (8 case),oblique fracture (12 case),spiral fractur(e1 case) and splintered fractur(e18 case). According to the fracture sites, all of the cases were divided into 3 types, including lower segment fracture (30 case), middle fracture (7 case), and superior segment fracture (2 case). 2 cases were open reduction by making a small incision. And there were 5 cases of fibula fracture which were reset and fixed by operation. After the operation, nursing care of pin track, early weight bearing exercise, and the dirigation were taken care of.ResultsAll of the 39 cases were followed up, and the mean follow-up time was 23.6 months (range 11months~34months). There was no nonunion and deformity in all of the cases. According to the Paley score standard, the excellent result (bone healing, no infection , malalignment<7°, leg length inequality <2.5cm) were got in 26 cases, the satisfactory result(bone healing, any two of the aforementioned finally 3 items) were got in 10 cases, the moderate result (bone healing, any one of aforementioned finally 3 items) was got in 3 cases, and poor result (bone healing, bone infection, malalignment>7°, leg length inequality >2.5cm) was found in 0 case, the good rate was 92.3%. But delay union was found in 4 cases, pin track infection was found in 2 cases (Without deep infection and screws loose), and screws breakage was found in 1 case. The dysfunction of ankle joint approximately resumed normal through dirigation, which were found in 4 cases that were fixed bridge across the ankle joint.ConclusionsUsing single-frame external fixator for tibiofibular fractures in children is a relatively safety, convenient and fast therapy method for pediatric tibiofibular fractures. It owned obvious advantage including small skin wound, tiny tissue damage, no influence of blood circle at the fracture site, firmly fixation, and they all fit with biological osteosynthesis theory (BO). Meanwhile, it also had the superiority of fast recovery, short time in hospital, early weight bearing exercise dirigation, reduction of the occurrence of the joint dysfunction and controllable complications. The good design of single-frame external fixator make it suitable for almost all types of tibiofibular fractures in children, especially accompanied by severe soft tissue damage which need long time changeover after the restoration, or accompanied by vessels or nerve injury; But the single-frame external fixator is not suitable for the cases that accompanied by serious osteoporosis, widely skin lesions, and some of cases which cannot cooperate with postoperative management for the reason of age or other factors.