OBJECTIVE: To evaluate the effectiveness of the pinless external fixator for the provisional treatment of Gustilo and Anderson grade I and II open fractures. METHODS: In a prospective study, 36 open diaphyseal fractures of the tibia were sequentially treated with a pinless fixator followed by massive, blocked, non-edged intramedullary nail. Mean age was 28 years, and 88.9% of the patients were male. The mechanism of trauma was: motorcycle accident in 47.1%, being run over by vehicle in 36.1%. Among the patients, 9 (25.0%) had associated lesions. According to the AO classification, 12 patients (33.3%) had suffered type A fractures, 18 patients (50.0%), type B fractures, and 6 patients (16.6%), type C fractures. According to the Gustilo and Anderson classification, 13 patients (36.1%) had grade I opened fractures, and 23 (63.9%) had grade II fractures. The mean time of external fixation was six days, ranging from 3 to 22 days. RESULTS: 32 patients had a satisfactory evolution. Fixator-related complications were seen in four patients: in three, the installed fixator could not be converted, and one had surface fibular neurapraxia. CONCLUSION: The pinless external fixation helps as provisional fixation of open diaphyseal fractures of the tibial when the intention is to later convert to intramedullary osteosynthesis.
Tibial fractures; Open fractures; Diaphysis; External fixators; Intramedullary fracture fixation; Prospective studies
