Innovative Use of Joshi's External Stabilization System for Tibial Fractures Complicated by Skin and Soft-Tissue Issues: A Case Series.

Abstract

Introduction: Tibia shaft fractures are common orthopedic injuries, and when accompanied by skin complications or with an impending compartment syndrome picture, they present unique challenges in terms of treatment and patient outcomes. Various treatment strategies have been employed for better management of the same. However, external fixation devices are frequently used in orthopedic surgery. Applying a fixator correctly can speed up the healing process while applying it incorrectly will slow it down. This article presents a case series of five patients detailing the successful management of a tibia shaft fracture complicated by skin issues through the application of Joshi's External Stabilization System (JESS) fixator.

Case report: We are presenting four cases of tibia fractures with skin problems that may be acute or chronic where it is confusing whether to treat it with internal or external fixation. Patients underwent a single staged external fixation using the JESS with or without debridement, which was followed up for a period of 12 months. In all five cases, we were able to achieve the resolution of skin complications and union of fractures with no reported complications.

Conclusion: This outcome of innovative technique guides us through the surgical dilemma with excellent outcomes within a single stage with consolidation of fracture and a resolution of soft-tissue recovery of soft tissues. Thus, it is a reliable option for treating complex tibial fractures with soft-tissue involvement.