Injuries of Lower Limb
Fracture lower 1/3rd of tibia, later presented with discharging sinuses with 4 cm shortening. Appropriate management is
a. All the options mentioned are used in treatment of fractures of tibia. But there are two peculiar things
b. in this question. One is that this fracture is compound grade I (as discharging sinus is there) other thing is that there is 4cm shortening.
c. External fixator --à are used in compound fracture but it will not correct shortening.
d. Plates----à has very limited role in tibial fracture now a days because of more newer device. Because tibia is subcutaneous bone internal fixation with plates leads to more chances of infection. Another thing that this is a compound fracture which is also a contraindication of internal fixation.
e. Interlocking nails---à nailing also will not correct shortening.
f. So best option in this question is Illizarov fixator as it will correct shortening with gradual distraction and can also lead to healing of wound.
Further these lines
a. Difficult nonunion with bone loss, deformity, or infection also have been managed effectively with this type of fixation (Campbell’s surgery 10th e P…2767
b. Open fractures with extensive bone loss are another indication for the Illizarov method (Campbell’s surgery 10th Pg……2768