Treatment of Open Leg Fractures by Intramedullary Nailing

Introduction: Open fracture is a loss of bone continuity that puts the bone in contact with the external environment through the wound. Open tibia shaft fractures are one of the most devastating orthopedic injuries. The aim of this current study is to analyze the results of the management of these series of recent open fractures of the leg. Patients and methods: This was a retrospective study over a period of 18 months involving 27 cases of open fractures of the leg treated with intramedullary unreamed nailing. Type I and II of Gustillo Anderson open fractures were included in this study, and were treated at the hospital during the period of the study by this nailing technique. The cases included 20 males (74.8%) and 7 females (20.2%), and the average age was 31 years (17-60 years). Results: The average duration of hospitalization was 16 days (12-30 days). On leaving the hospital, patients received the combination oxacillin-Lincocine oral antibiotics. The average time for bone consolidation was 115 days (90-140 days). Some complications were reported: 2 cases of secondary drifting of suture occurred postoperatively among 2 type II fractures. Local care and a secondary suture using U points led to wound healing without removal of the nail. A case of late infection occurred without impact on consolidation. Conclusion: Treatment of open fracture of the leg remains controversial. But increasingly, the idea of an early internal fixation by intramedullary unreamed nailing is gaining ground.