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Grade II Open Tibial Fractures

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div class="bodycopy">- See: a href="/bones/tibia-fibula/gustilo-classification-of-open-tibial-frxs/">Gustilo Classification/a>:br/>
strong>- Treatment Options:/strong>br/>
     - a href="/bones/tibia-fibula/external-fixators-for-tibial-frx/">external fixation/a>:br/>
     - a href="/bones/tibia-fibula/tibial-fractures-technique-of-im-nailing/">intra-medullary nail/a>;br/>
           - IM devices control length and rotation as effectively as a href="/bones/tibia-fibula/external-fixators-for-tibial-frx/">Ex Fix/a>   (w/o complications of soft tissue inpalement & pin tract infection)br/>
           - despite the recent interest in nonreamed interlocking IM nailing for open tibial fractures, there is good evidence to suggest that reamed interlockingbr/>
                   nails result in a lower rate of complications (screw breakage) and have a similar time to bone union (a onclick="window.open(this.href,'','resizable=no,location=no,menubar=no,scrollbars=yes,status=no,toolbar=no,fullscreen=no,dependent=no,status'); return false" href="http://www.ncbi.nlm.nih.gov/pubmed/9070520">Keating JF, et al/a> (1997));br/>
                   - a onclick="window.open(this.href,'','resizable=no,location=no,menubar=no,scrollbars=yes,status=no,toolbar=no,fullscreen=no,dependent=no,status'); return false" ref="linkpos=2&log$=citationsensor" href="http://www.ncbi.nlm.nih.gov/pubmed/9070520">Locking intramedullary nailing with and without reaming for open fractures of the tibial shaft. A prospective, randomized study./a> br/>
           strong>- relative contraindications:/strong>br/>
                   - marked delays in treatment (more than 8 - 10 hrs) at which point, the wound may be considered infected (rather than contaminated);br/>
                   - marked contamination of open frx that can't be thoroughly debrided;br/>
                   - a href="/bones/tibia-fibula/open-tibia-frx-exchange-nailing/">exchange IM nailing/a> may be preferable in these cases/div>br/>hr/>br/>br/>br/>Last updated by Clifford R. Wheeless, III, MD on Monday, April 1, 2013 9:37 pmbr/>