Purpose: To evaluate the results of the treatment of tibia fractures with external fixation and subsequently exchanging it to intramedullary osteosynthesis

Material and Methods: This is a retrospective study of 25 tibia fractures which were treated in our institution between January 2002 and December 2005. There were 17 men and 8 women with an average age of 32 years (range, 19 to 70). According to AO-OTA there were 7 type B2, 12 type C1, 3 type C2 and 3 type C3. All fractures were open (Gustilo Anderson type I (2), type II (8), type III (15). The planned treatment protocol included provisional management with external fixation and sequential converse to a static intramedullary nailing. The mean duration of external fixation was 9 3 weeks (range, 2 to 7). In all cases nailing was preceded by a period in plaster lasting an average of 4 weeks.

Results: All patients were reviewed after an average time of 12 months (range 9–21). Bone union was noted in all fractures at an average of 19 weeks (range, 8 to 32) after the intramedullary nailing. There was one case with deep infection, without compromising the consolidation of the fracture. A leg shortening from 1.5 cm to 3 cm was recorded in 6 cases. Angular malalignment from 2° to 5° of tibia was recorded in 2 cases. 3 additional surgeries for leg lengthening were recorded but no further surgery due to the tibia malalignment was needed.

Conclusions: The management of open tibia fracture remain a challenging problem. Exchange of the external fixation to intramedullary nailin is a safe and effective treatment modality of managing of these difficult tibia fractures.