Evaluation of non-contact brigde plating as an internal fixator in the management of open diaphyseal fractures of long bones

Introduction: Management of open fractures pose great challenge to the operating surgeon. Most common problems encountered are related to soft tissue and delayed and non-union. Initially many treatment methods were used for these types of fracture fixation, but each method had its pros and cons. So we undertook this study to understand the use non-contact locking plate for the management of these fractures. Aims and Objectives: Evaluation of non-contact brigde plating as an internal fixator in the management of open diaphyseal fractures of long bones Materials and Methods: The present study was conducted in the Department of Orthoapedics and Traumatology, M.G.M. Medical College and M.Y. Hospital, Indore during the study period August 2017 to August 2019. A total of 25 patients with compound fractures of long-bones were included. The inclusion criteria was (1) Open fractures of long bone (G.A. type II, IIIA andIIIB); (2) Patient who presented within 48 hours of injury with no signs of infection. Radiological assessment was done by ASAMI criteria and functional results were evaluated on the basis of: (a) A clinically detectable limp; (b) Stiffness of the knee or ankle; (c) Soft tissue reflex sympathetic dystrophy; (d) Pain that reduces activity or disturb sleep and (e) Loss of activity. Results: The mean age was 30.2 years with a male preponderance (96%). Road traffic accident accounting for 92% of the injuries. Majority of the patients were having Gustilo-Anderson type-II fractures (40%). In patients with tibia fractures, 82.4% had complete union and 17.6% had non-union. All of the 5 femur and 3 humerus fractures showed complete union. The mean union time was 21.86 weeks. According to ASAMI criteria, 44% patients had excellent 36% had good and 12% had poor bone result.Functional results were assessed based on ASAMI criteria 24% patients achieved excellent, 36% had goodand 16% patients had poor functional outcome.4 (16%) patients require split skin grafting, 1 (4%) patient required flap surgery for the closure of wounds. Conclusion: NC-LP can be an important armamentarium in treatment of open fractures of long bones which can enhance bone union and permit soft tissue management simultaneously.