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External fixation versus locked intramedullary nailing in tibial shaft fractures: a prospective, randomised study of 78 patients

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Abstract

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.

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Authors and Affiliations

  1. Department of Orthopedics, University Hospital, 7006, Trondheim, Norway

    Martinus Bråten, Torbjørn Grøntvedt, Arild Aamodt & Pål Benum

  2. Haukeland University Hospital, 5021, Bergen, Norway

    Per Helland & Anders Mølster

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  1. Martinus Bråten
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  2. Per Helland
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  3. Torbjørn Grøntvedt
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  4. Arild Aamodt
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  5. Pål Benum
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  6. Anders Mølster
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Correspondence to Martinus Bråten.

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Bråten, M., Helland, P., Grøntvedt, T. et al. External fixation versus locked intramedullary nailing in tibial shaft fractures: a prospective, randomised study of 78 patients. Arch Orthop Trauma Surg 125, 21–26 (2005). https://doi.org/10.1007/s00402-004-0768-0

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  • DOI: https://doi.org/10.1007/s00402-004-0768-0

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