Table of Contents
ISRN Orthopedics
Volume 2014, Article ID 721041, 7 pages
Clinical Study

A Staged Surgical Treatment Outcome of Type 3 Open Tibial Fractures

1Departments of Orthopedics and Traumatology, Afyonkarahisar State Hospital, Orhangazi Mah. Nedim Helvacıoglu Caddesi No. 73, 03100 Afyonkarahisar, Turkey
2Department of Emergency Medicine, Bağcılar Education and Research Hospital, Istanbul, Turkey
3Departments of Orthopedics and Traumatology, Ankara Education and Research Hospital, Ankara, Turkey

Received 21 February 2014; Accepted 20 March 2014; Published 15 April 2014

Academic Editors: S. Kamineni and V. S. Nikolaou

Copyright © 2014 Ahmet Aslan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Aim. In these case series which are about type 3 open tibial fractures formed with three different high energy trauma etiologies in different parts of tibia. We aimed to assess our three-stage treatment approach and discuss final results of our elective surgery management with three different fixation methods. Patients and Methods. We assessed 19 patients with type 3 open tibial fractures between 2009 and 2012. Our treatment protocol consisted of three stages. Early intervention in operating room, which including vascular repairs or soft tissue closure, was done if necessary. Definitive surgery was performed using internal or external fixation in the first 15 days. Patients were followed up for at least one year. Last conditions of all our cases were evaluated according to modified Johner and Wruhs criteria. Results. Nine cases were type 3A, seven cases were type 3B, and three cases were type 3C in terms of fracture typing. All patients were followed up for at least one year and mean follow up time was 15 months. In terms of functional and clinical outcome, six cases were evaluated as excellent, eight cases as good, two cases as fair, and three cases as poor. Discussion. Staged treatment option in type 3 open tibial fractures seems to be a good method in reducing complication and achieving the best result. We think that definitive staged treatment protocol including internal fixation with plating or intramedullary nailing (IMN) of the fractures is a reliable method, especially to avoid complications as a result of external fixator and to provide patient rapport.