Comparison of Immediated and Delayed Internal Fixation for Open Upper Extremity Fracture (Gustilo Type II)

Abstract

          Objective: To compare the result of treatment for the patient with open upper extremity fracture (Gustilo Type II) by immediated and delayed internal fixation.

          Material and methods: Prospective randomized control study was done at Samutsakhon Hospital from 1st September 2010 - 31th January 2012. The patients with open fractures shaft of upper extremies (Gustilo Type 11) were classified randomly into 2 groups by coin. The first group had debridement and immediated internal fixation with plates and screws. The second group had debridement and delayed internal fixation within 72 hours. Comparison of the infection rate and the union rate of the two groups was done.

          Results: There were 26 patients (28 fractures) in this study. The first group had 15 patients (15 fractures) aged 27.87 ± 11.70 years. The second group had 11 patients (13 fractures) aged 23.91 ± 6.53 years. One patient (6.7%) in the first group had wound infection and non in the second group but no statistical significance (p-value = 1.00). All patients had bony union. The first group had union of Humerus at 15.50 ± 3.21 weeks and forearm at 9.67 ± 2.50 weeks. The second group had union of Humerus at 15.33 ± 3.06 weeks and forearm at 10.50 ± 3.72 weeks but no statistical significance (p-value = 0.94 and 0.58 respectively).

          Conclusion: The patients with open upper extremity fracture (Gustilo Type 11) who had debridement and immediated internal fixation with plates and screws or delayed internal fixation had the same result in the rate of wound infection and the rate of bony union.