Abstract: Introduction: Study is to evaluate the outcome of fixation of compound fractures of distal tibia by JESS fixator and to analyse the soft tissue healing and fracture union, functional outcome. Different modalities of treatments are available for this fractures, timing of surgery plays a vital role in the management of this compound fractures of distal Tibia with condition of the soft tissues. Although the severity of these injuries, complexities of a variety of treatment methods, and limitations of management having been well documented in the literature, excellent long-term results of treatment continue to elude patients sustaining these fractures. The open fractures of distal tibia are very common, and which adds complexity to distal tibial fracture treatment and union. So this study is a prospectively evaluating the results of compound fractures of distal tibia (AO 43-A) that is extra articular fractures managed using JESS fixator.
Material and Methods: Patients with distal tibia fracture with compound injury are selected for the study. Study conducted in Gulbarga institute of medical science (GIMS) department of orthopaedics Kalaburgi, Karnataka from January 2017 to December 2018. Total 12 patients selected with the criteria and treated with jess and followed up for 12 months. Antibiotic prophylaxis with injection given preoperatively and continued till 5th postoperative day. Regular dressing and knee and ankle passive and active mobilization started from day one. And non-weight bearing till three weeks and gradual weight bearing after 3 weeks. On an average patient discharged on 15th postoperative day, then regular followed-up. Check x-ray done first postoperative day. Another x ray done before jess removal that is on 6-8 week postoperative. Patient followed up closely and the functional outcome, ankle range of motion assessed.
Results: The evaluation, based on clinical and radiographic findings and subjective complaints of the patients, was made with the use of the American Orthopaedic Foot and Ankle Society score (AOFAS). 12 patients were followed up. AOFAS scoring: excellent in 83% (10). Average hospital stay: 15 days. Non union in one case and infection in one case.
Conclusion: JESS fixator is a safe and useful modality in compound tibial fractures as definitive modality, however caution is advocated as cohort is short.
