A Prospective Analysis of Outcome in Conversion of External Fixators to Internal Fixators in Open Fractures of lower Limbs
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Open fractures occur as a result of great violence. Hence they are associated with considerable damage to the soft tissue envelope due to dissipation of the energy, displacement and comminution of long fragments. Secondary to this, there is local disruption of blood supply which results in more necrotic tissues. This impedes new angiogenesis as well as decreases the viability of the mesenchyme cells. Because of the severe violence, this fracture may be of compound nature. This deals to even more necrosis and by predisposing to infection, it further increase the risk of non-union. These high velocity injuries majority were associated with bone loss. These fractures requires staged reconstruction, it further increase the risk of nonunion. Some surgeons use external fixation as a primary treatment until the soft tissues have healed and then employ another technique to secure union. Theoretically, the biomechanical and biological advantages of reamed intramedullary nailing would be expected to give good results, but the method has hazards, in particular infection. We therefore performed a prospective study to analyse the outcome of conversion to internal fixators in open fractures of lower limbs.
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