Complications associated with hexapod circular fixation for acute fractures of the tibia diaphysis: A retrospective descriptive study at a high volume trauma centre

• Published in: Injury Vol. 51; no. 2; pp. 516 - 521
• Main Authors: Potgieter, Maarten SW, Pretorius, H Sean, Preez, Gian Du, Burger, Marilize, Ferreira, Nando
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.02.2020
• Subjects: Circular fixator; Complications; Hexapod; Tibia fractures; Circular fixator; Complications; Hexapod; Tibia fractures
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2019.11.012

•Good clinical outcomes and acceptable complication rates were associated with the use of hexapod fixation for the management of high energy tibia shaft trauma in a high volume trauma centre.•We advise that fracture alignment should be obtained prior to discharge to counter problems with poor patient compliance.•Pin site infections are frequently encountered however most of them are low grade infection that responds well to topical care. The use of hexapod circular external fixation in acute tibia fracture care is increasing as more general orthopaedic surgeons are gaining expertise with the use of this treatment modality. Limited data is currently available on the complications that may be encountered with this treatment strategy. Aim: To review the complications and outcomes of acute diaphyseal tibia fractures definitively treated with hexapod circular external fixation at a high volume orthopaedic trauma centre. Methods: Retrospective review of clinical and radiological data of adult patients with acute diaphyseal tibia fractures treated with hexapod external fixation between 2012 and 2015 at a single centre. Results: A total of 102 diaphyseal fractures were definitively treated with hexapod circular external fixation. Union was achieved in 101 cases with an average time to union of 25.6 weeks. Complications included pin site infection (56%); wound complications (19.67%); osteitis (11.76%); malunion (15.69%) and knee and ankle joint contractures (31.32%). Conclusion: Hexapod circular external fixation as definitive treatment of for diaphyseal tibia fractures demonstrates an excellent union rate with acceptable time to union. Complications rates are comparable to that of all fine wire circular fixators. Malalignment in is however a concern, considering that this device enables the surgeon to achieve accurate alignment through gradual deformity correction aided by computer software.