Complications of NA External Fixator in patients who Underwent Tibial Lengthening Surgery

Abstract

Aim: To determine the spectrum of different complications during tibial lengthening procedure using NA external fixator in our patients at GMC, Gujranwala, and KEMU, Lahore, Pakistan. In addition, this study will also find significant factors associated with occurence of complications in NA fixator-assisted lengthening surgery.

Methods: This was a cross-sectional study. The patients who underwent tibial lengthening procedure using NA external fixator were categorized into two categories: fixator complications group and no complications group. Statistical analysis was done using SPSS version 25. Independent sample T test and Chi-square test for independence were used for quantitative and qualitative variables respectively to determine their significant association with the occurrence of complications during tibial lengthening procedure. The p-values were taken statistically significant if < 0.05.

Results: Out of a total of 100 patients, 26% suffered loosening of pin, 2% breaking of pin, 2% loosening of pin, 2% loosening of clamp, 2% breaking of clamp, while 66% had no complications. 52% got skin reaction to pins. The occurrence of complications of NA external fixator was significantly lower at younger age (p=0.022). It has positive association with the number of pins inserted during procedure (p=0.037) and negative association with the duration of hospitalization (p=0.003). The complications of NA external fixator occurred more after left leg surgery as compared to after right leg surgery (p=0.012) and were associated with post healing pain (p=0.042).

Conclusion: Skin reaction to pins was the commonest complication of NA external fixator in our studied population. The risk of complications of NA fixator had positive correlation with increasing age and number of pins inserted during tibial lengthening procedure. The duration of hospitalization was less while post-healing pain was more among patients in which complications of NA fixator occurred. Complications occurred relatively more after left leg surgery in comparison to right leg surgery. Minimum number of pins should be inserted during lengthening procedure especially in aged people to reduce fixator related complications and post-healing discomfort