부산대학교 도서관

Ahmed Albushtra,1 Abdulsalam Hadi Mohsen,2 Khaled Ali Alnozaili,3 Faisal Ahmed,4 Younes Mohsen Ali Abdu Aljobahi,1 Fawaz Mohammed,1 Mohamed Badheeb5 1Department of Orthopedic, School of Medicine, Ibb University, Ibb, Yemen; 2Department of Orthopedic, School of Medicine, Aden University, Aden, Yemen; 3Department of Orthopedic, School of Medicine, 21 September University, Sana’a, Yemen; 4Department of Urology, School of Medicine, Ibb University, Ibb, Yemen; 5Department of Internal Medicine, Yale New Haven Health, Bridgeport Hospital, Bridgeport, CT, USACorrespondence: Faisal Ahmed, Department of Urology, School of Medicine, Ibb University, Ibb, Yemen, Tel/Fax +967 4428950, Email fmaaa2006@yahoo.comBackground: External fixation is one of the most often utilized treatment options for complicated tibial diaphyseal fractures (TDF). The purpose of this study was to assess the efficacy of unilateral external fixators as primary and definitive therapy for complex TDF in a resource-limited setting.Materials and Methods: A retrospective study between June 2016 and March 2021 included 110 subjects with TDF who were treated with an external fixator as definitive fixation in hospitals affiliated with Ibb University. The patient’s demographic characteristics, complications, and outcomes were gathered and analyzed. Factors associated with pin site infection were also investigated.Results: The mean age was 42.1 ± 10.1 years, with 92.7% being male. Rural residents accounted for 22.7%. Smoking and diabetes mellitus were present in 27.3% and 30.0%, respectively. General complications occurred in 12.0%, with pulmonary embolism being the most common at 4.5%. Orthopedic complications included pin-track infections in 27.3% (30) and osteomyelitis in 1.8% (2). Pin site infections required medical treatment in 21 cases and external fixator changes in five. Two cases each needed several debridements for osteomyelitis and soft tissue. Full union occurred in 79.1% (87) over 23.1 ± 3.2 weeks and final alignment in 97.3% (107) over 34.8 ± 4.8 weeks. Malunions occurred in 1.8% (2), and one case had hypertrophic nonunion. Factors like rural residency, smoking, diabetes, open fractures, worst fracture grade (Gustilo and Anderson type C), and general complications occurrence significantly correlated with pin site infection (all p-values < 0.05).Conclusion: A unilateral external fixator as a primary and definitive treatment is a viable, simple, and effective option for TDF with a high success rate even in a resource-limited setting. In this study, residents in rural areas, smoking, diabetes, open fracture, worst fracture grade, and general complication occurrence were associated with pin site infection occurrence.Keywords: external fixation, definitive treatment, tibial fractures, pin tract infection