INTRODUCTION: We performed a prospective, randomised study to compare the Ex-fi-re external fixator (EF) with locked intramedullary (IM) nailing in tibial fractures. Only fractures without soft-tissue problems of importance were included. MATERIALS AND METHODS: Ex-fi-re is a unilateral, dynamic axial fixator with fracture reduction capabilities. The Grosse-Kempf nail was used for nailing. A total of 78 patients with 79 fractures were entered in the study (41 Ex-fi-re, 38 IM nails). RESULTS:Time to radiographic union and full weight-bearing did not differ significantly, but unprotected weight-bearing was achieved earlier in the IM group (12 vs 20 weeks; p<0.001). There were more reoperations due to secondary dislocation in the EF group. There were no differences in final angulation or shortening. After 6 months and 1 year there were no differences in knee motion, ankle motion, fracture site pain or ankle pain. Some 64% of the nailed patients complained of anterior knee pain after 1 year. CONCLUSION: The results were comparable in most respects. Unprotected weight-bearing was achieved earlier after IM nailing. Anterior knee pain was frequent after nailing.
RCT Entities:
INTRODUCTION: We performed a prospective, randomised study to compare the Ex-fi-re external fixator (EF) with locked intramedullary (IM) nailing in tibial fractures. Only fractures without soft-tissue problems of importance were included. MATERIALS AND METHODS: Ex-fi-re is a unilateral, dynamic axial fixator with fracture reduction capabilities. The Grosse-Kempf nail was used for nailing. A total of 78 patients with 79 fractures were entered in the study (41 Ex-fi-re, 38 IM nails). RESULTS: Time to radiographic union and full weight-bearing did not differ significantly, but unprotected weight-bearing was achieved earlier in the IM group (12 vs 20 weeks; p<0.001). There were more reoperations due to secondary dislocation in the EF group. There were no differences in final angulation or shortening. After 6 months and 1 year there were no differences in knee motion, ankle motion, fracture site pain or ankle pain. Some 64% of the nailed patients complained of anterior knee pain after 1 year. CONCLUSION: The results were comparable in most respects. Unprotected weight-bearing was achieved earlier after IM nailing. Anterior knee pain was frequent after nailing.
Authors: Michail Beltsios; Andreas F Mavrogenis; Olga D Savvidou; Eirineos Karamanis; Zinon T Kokkalis; Panayiotis J Papagelopoulos Journal: Eur J Orthop Surg Traumatol Date: 2013-06-16
Authors: Ali Çağrı Tekin; Mehmet Selçuk Saygılı; Müjdat Adaş; Haluk Çabuk; Samet Murat Arslan; Süleyman Semih Dedeoğlu Journal: Med Princ Pract Date: 2015-12-10 Impact factor: 1.927
Authors: Mandala S Leliveld; Michael H J Verhofstad; Eduard Van Bodegraven; Jules Van Haaren; Esther M M Van Lieshout Journal: Eur J Trauma Emerg Surg Date: 2020-08-09 Impact factor: 3.693