C. J. Manikumar1 , B. S. S. S. Venkateswarlu2 , K. Chiranjeevi3 , A. Deepak4
BACKGROUND Open fractures are more prone for non-union as there is extensive damage to endosteal and periosteal blood supply. Probability of non-union increases with severity of open wound. As the plate is at a distance from the bone, there is less soft tissue dissection. It is less rigid than the internal fixation with locking plate. Load sharing during weight bearing may stimulate the developing callus until bony union. Multiple locking holes in the metaphyseal region of the pre contoured plates provide more stability compared to the standard two large external fixator pins. Though it is recommended that external locking plate has to be used as an external fixator to convert a compound fracture into a simple fracture, as an alternative to external fixator, as they are less cumbersome and more rigid compared to the conventional external fixator, surprisingly, it is also contributing for the union of fracture, in addition to converting a compound to simple fracture, in majority of the cases. METHODS This is a prospective interventional and observational study of 23 cases of compound tibial fractures managed with external locking plate in the Department of Orthopaedics, Government General Hospital, Rangaraya Medical College, Kakinada. RESULTS Proximal tibial fractures took 20 weeks to unite; middle 3rd fractures took 24 weeks and distal 3rd fractures took 22 weeks for union. Most common complication was superficial infection. CONCLUSIONS External plating has good patient compliance as it is comfortable, convenient, and can be easily covered by the trousers due its less bulky construct. They have low profile and hence needs less space for clearance and hence, less likely to hit the opposite limb in swing phase of gait cycle. It can easily be removed under local anaesthesia.
