Osteosynthesis and Trauma Care 2002; 10(Suppl 1): S25-S26
DOI: 10.1055/s-2002-33812
© Georg Thieme Verlag Stuttgart · New York

Dynamic External Fixation for Open Tibial Fractures

S. Kalos, A. Giannakopoulos, C. Tzioupis, M. Dagiakidis, N. Kontozoglou, G. Skouteris
  • Second Orthopaedic Clinic Asklepeion Voulas Hospital, Athens, Greece
Further Information

Publication History

Publication Date:
11 September 2002 (online)


The treatment of open tibial fractures remains controversial. The choice of technique for stabilisation needs to be analysed. External fixation has numerous complications at pin sites, non-union or delayed union [4] [10] [17]. The biomechanical and biological advantages of intramedullary nailing in closed fractures have been expanded to open tibial fractures with  the potential risk of infection and instability [18]. Our policy is to treat closed tibial and open type I fractures conservatively or with reamed interlocking intramedullary nailing and type II or type III with external fixation. The purpose of this paper is to analyse the results of dynamisation of external fixation and comparison with the simple unilateral static frame.


  • 1 Barquet A, Massafferro J, Dubra A, Milans C, Castiglioni O. The dynamic ASIF-BM tubular external fixator in the treatment of open fractures of the shaft of the tibia.  Injury. 1992;  23 461-466
  • 2 Checketts R G, Moran C G, Jennings A G. 134 tibial shaft fractures managed with the Dynamic Axial Fixator.  Acta Orthop Scand. 1995;  66 271-274
  • 3 De Bastiani G, Aldegheri R, Renzi Brivio L. The treatment of fractures with a dynamic axial fixator.  J Bone Joint Surg [Br]. 1984;  66 538-545
  • 4 Edge A J, Denham R A. External fixation for complicated tibial fractures.  J Bone Surg [Br]. 1981;  63 92-97
  • 5 Emami A, Mjoberg B, Karlstrom G, Larsson S. Treatment of closed tibial shaft fractures with unilateral external fixation.  Injury. 1995;  26 299-303
  • 6 Gustilo R B, Mendoza R M, Williams D N. Problems in the management of type III (severe) open fractures: a new classification of type III open fractures.  J Trauma. 1984;  24 742-746
  • 7 Hay S M, Rickman M, Saleh M. Fracture of the tibial diaphysis treated by external fixation and the axial alignment grid: a single surgeon's experience.  Injury. 1997;  7 437-443
  • 8 Heim D, Marx A, Hess P, Schlapfer R, Regazzoni P. External fixator as primary and definite treatment of tibial fracture with severe soft tissue damage.  Helv Chirg Acta. 1991;  57 839-846
  • 9 Hessmann M, Mattens M, Rumbant J. The unilateral external fixator (Monofixator) in acute fracture treatment: experience in 50 fractures.  Acta Chir Belg. 1994;  4 229-235
  • 10 Karlstrom G, Olerud S. External fixation of severe open tibial fractures with the Hoffmann frame.  Clin Orthop. 1983;  180 68-77
  • 11 Keating J F, Gardner E, Leach W J, Macpherson S, Abrami G. Management of tibial fractures with the Orthofix dynamic external fixator.  J R Coll Surg Edinb. 1991;  36 267
  • 12 Kimmel R B. Results of treatment using the Hoffmann external fixator for fractures of the tibial diaphysis.  J Trauma. 1982;  22 969-975
  • 13 Korovessis P, Milis Z, Christodoulou G, Spastris P, Sdougos G, Katsoudas G, Voutsinas A. Open tibial shaft fractures: a comparative analysis of different methods of fixation in southwestern Greece.  J Trauma. 1992;  32 77-81
  • 14 Krettek C, Haas N, Tscherne H. Results of treatment of 202 fresh tibial shaft fractures, managed with unilateral external fixation (monofixateur).  Unfallchirurg. 1989;  92 440-452
  • 15 Patzakis M J, Wilkins J, Moore T M. Considerations in reducing the infection rate in open tibial fractures.  Clin Orthop. 1983;  178 36-41
  • 16 Rittman W W, Schibij M, Matter P, Allgower M. Open fractures. Long term results in 200 consecutive cases.  Clin Orthop. 1974;  138 132-149
  • 17 Templemann D C, Gulli B, Tshukayama T D, Gustilo B R. Update on the management of open fractures of the tibial shaft.  Clin Orthop. 1998;  350 18-25
  • 18 Whittle A P, Wester W, Russel T A. Fatigue failure in small diameter tibial nails.  Clin. Orthop 1995;  313 119-128

St. Kalos M.D.

Second Orthopaedic Clinic

Asklepeion Voulas Hospital