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            [0] => External fixation in distal tibia fractures : long-term outcomes, in 35 cases
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    [etablissement] => Array
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            [0] => Rabta hospital
        )

    [nom] => Array
        (
            [0] => khlif
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    [prenom] => Array
        (
            [0] => mohamed ali
        )

    [email] => Array
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            [0] => dalykhlif1@yahoo.fr
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            [0] => 27256830
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Nom prénom / Name Surname: Mahjoubi Seifeddine
Email: seifeddinemahjoubi@gmail.com
Hôpital / Hospital: Rabta hospital

 
Nom prénom / Name Surname: Khlif Mohamed Ali
Email: dalykhlif1@yahoo.fr
Hôpital / Hospital: Rabta hospital

 
Nom prénom / Name Surname: Mbarki Sami
Email: sami.mbarki@etudiant-fmt.utm.tn
Hôpital / Hospital: Rabta hospital

 
Nom prénom / Name Surname: Ben Ayed Mehdi
Email: b.ayed.mehdi@gmail.com
Hôpital / Hospital: Rabta hospital

 
Nom prénom / Name Surname: Zitouna Khaled
Email: kh.zitouna@laposte.net
Hôpital / Hospital: Rabta hospital

 
Nom prénom / Name Surname: Barsaoui Maher
Email: barsaoui.maher@yahoo.fr
Hôpital / Hospital: Rabta hospital

        )

    [mots_cles] => Array
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            [0] => distal tibia fracture;
external fixation;
outcome;

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            [0] => 3663
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            [0] => dalykhlif1@yahoo.fr
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    [specialite] => Array
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            [0] => Chirurgie orthopédique et traumatologique
        )

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            [0] => Tunisie
        )

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            [0] => Background: Distal tibia fractures occur especially on young patients. These fractures result from high energy trauma. Management of these injuries is challenging and proportional to the degree of comminution. We aimed to study long-term clinical and radiological outcome of distal tibia fractures treated by external fixation as well as its complications.

Methods: We undertook a retrospective study in 35 patients with distal tibia fractures which were treated with external fixation in La Rabta university hospital during 8 years from January 2006 to January 2014. Our functional and radiological assessment criterias were respectively the score of Le Chevallier and the Kellgren and Lawrence score.

Results: The median age was 38.4 years ± 14.8 years. The sex ratio was 1.9. The main cause of the injury was a fall from a height (71.5%). Nearly twelve percent of closed fractures were graded I according to Tscherne and Goetzen classification. Fibular fractures were associated in more than 50%. According to the AO classification, 14.2% were type B1, 20% type B2, 20% type C2 and 25.8% type C3. The mean surgical delay was 1.8 day. Minimally invasive osteosynthesis was used in 76% of cases. Half of patients underwent fibular fixation. The mean length of hospital stay was 5 days. The external fixator was removed after a mean period of 11 weeks. 
There were 5.7% of superficial pin tract infections and one deep-seated pin tract infection. Thirty four percent of patients developed algodystrophy. Osteoarthritis, instability and non union were seen respectively in 25.7%, 2.8% and 2.8% of patients. 
Le Chevallier score was good in 18 patients (51.5%), fair in 8 (22.8%) and poor in 9 (25.7%). Kellgren and Lawrence score was good in 28%, fair in 43% and poor in 26%.

Conclusion: Distal tibia fractures treated with external fixation are associated with high rate of complications. The use minimally invasive osteosynthesis improves functional and anatomic outcomes especially with highly comminuted fractures.
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