Management of Open Fractures of Shaft of Tibia in Adults-A Comparative Study

Introduction: Open fractures of the tibia remain a formidable injury in todays motorized society for two reasons-they are common and they can be very challenging fractures to care for. Treating the spectrum of bone and soft tissue injuries that accompany open fractures of the tibia requires experience and judgement, an inadequate or inappropriate tratement can lead to severe complications and major disability. The prolonged nature of treatment of open tibial fracture frequently results in disruption of all aspects of patient’s life, high health service expenditure and loss of productivity to nation. The higher the expectation by the patient and the society for improved functional outcome from the treatment of the tibial fractures continue to challenge the surgeon. The presence of contamination is the major difference between the open and the closed fractures. If, by proper tissue management contamination is prevented from progressing to infection, the open fracture will heal in a similar way as the closed fracture. The fundamental principles of management of open fractures of the tibia are well accepted; these include immediate exploration, irrigation and debridement, bony stabilization appropriate use of antibiotic therapy repeated wound debridement and early soft tissue coverage is published in various series by Burgess AR 1 , Chapman 2 , Rhinelander 3 , Gustillo RB 4 etc.