The use of Pin-In-Plaster Technique in The Management of Complex Tibial Fractures, the Calabar Experience

BACKGROUND: This study highlights the difficulties of managing complex limb injuries by specialists working in areas where there are scarce resources and the methods used in overcoming the challenges. METHOD: A retrospective study of methods used in managing type III open tibial factures were analyzed at the University of Calabar Teaching Hospital between 1997 and 2001 focusing on the use of the pin in plaster (PIP) technique and conventional external fixators as initial management tools. RESULT: A total of 565 patients were treated for complex open tibial fractures within this period. Eighty-five (15%) of this were treated using Pin-in-plaster method while 25(4%) had conventional External fixation. Others were treated with Traction and or POP application. One hundred patients (18%) left against Medical advice (LAMA). The male: female ratio was 4:1 and they were in the age range 15-75 (mean 36.6) years. The commonest complication encountered was pin tract infection in 12 (48%) of those with external device and 30 (35.3%) in those with PIP. The outcome of treatment was satisfactory in 71% and 64% of PIP and external Fixator respectively while one (1%) patient among those with PIP died of tetanus. CONCLUSION: There is a need to equip our hospitals. Doctors working in the rural areas are to encouraged use this affordable and simple device in the initial management of complex tibial fractures, KEY WORD: Pin in Plaster, External fixation, complex tibial fractures, limb salvage Nigerian Journal of Orthopaedics and Trauma Vol.3(2) 2004: 163-16