A prospective study for TENS nailing as an alternative to external fixation in compound fractures of Tibia

Abstract

Background: The treatment of compound fractures remains a major problem especially with regards to wound coverage, high risk of infection and therefore poor outcomes. Moreover, the use of External Fixators can limit the activities of the patient due to the unwelcoming appearance and bulkiness of the apparatus. Materials and Methods: Gustilo Anderson II, IIIA, IIIB fractures of the diaphysis were included. A minimum of 2 and maximum 3 TENS (Titanium Elastic Nailing System) nails were used for fixation. The patients were followed up at 6, 12 and 24 weeks. The results were measured using Karlstrom & Olerud Criteria and Hammer et al. criteria. Results: A total of 27 patients with 28 compound fractures were treated with TENS nailing. Mean operating time was 39.34±9.15minutes, mean time to wound healing was 5.2±1.4 weeks. Functional results were Excellent to Good in 82.1% and Satisfactory in 17.9% fractures. There were no poor results. Radiological union was achieved in 24.6%, Delayed Union in 53.6%, and Non-Union in 17.9% fractures. The mean time to union was 19.5±3.8 weeks. Conclusion: We conclude that the use of TENS nail for the fixation of Compound Fracture of Long Bones of Lower Limbs is a feasible option with certain advantages pertaining to the better wound care, very good patient compliance, easy to perform, short operating time, excellent to good functional outcomes and lesser iatrogenic damage, infection and joint stiffness.