A prospective study of delta frame as external fixator for open-distal tibial fractures

Abstract

Distal tibial fractures pose a serious challenge to the orthopaedician because muscular coverage is very less and poorly vascularized [1]. It is further complicated by comminution, joint involvement, open fractures and high energy trauma [1]. The goals of management are proper care of the injured soft tissues, restoration of joint congruity, stable fixation [2]. Ankle spanning external fixation ie Delta frame has become the initial treatment of choice for complex tibial pilon fractures [3]. The ‘tripolar configuration’ allows facilitation of wound care, plastic procedures and good xray or CT images [4]. The Delta external fixator was found to be the most stable external fixator for treating not stable as type III according AO/OTA’s classification [5]. The IM nails often do not provide enough stability in distal tibial fractures and plating requires extensive soft tissue dissection [6]. External fixators can also be used in osteoporotic and unreconstructable comminuted metaphyseal fractures with poor bone stock [6]. However literature support is scanty, hence we decided to do the above study with an aim to analyze its results using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot score.