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When the star arrives, the barber takes the opportunity to brag about his last job - the one that made him a star - and the actor says he'd like to try it again. The next day, the barber gets the call. Will he be ready this time? Written by Dynamics of diaphyseal fractures of the tibia treated with external fixator. The treatment of diaphyseal fractures of the tibia has changed over the years. Initially, such fractures were treated with intramedullary nailing. In the early 1990s, flexible intramedullary rods with transverse Kirschner wires were introduced and the technique proved successful. Nevertheless, there are many complications associated with the use of intramedullary nailing, and intramedullary nailing is now being abandoned in favor of the use of external fixators. The main advantage of external fixation is that it does not cut the blood supply to the bone, and therefore, there is less risk of infection and necrosis of the fracture. The external fixator also permits rapid bony union of the fracture. This study was done to compare the incidence of problems associated with intramedullary nailing with those associated with the use of the external fixator. One hundred and thirty-seven patients with a mean age of 29.3 years were treated with intramedullary nailing and external fixation for diaphyseal fractures of the tibia. The overall incidence of complications was similar between the two methods. The two most common complications associated with the use of intramedullary nailing were infection and necrosis of the fracture. Sixteen patients had to have their devices removed because of infection. Twenty patients (17%) had bone healing problems. At a mean follow-up of 32.4 months, three of the six patients with nonunion were lost to follow-up. There was one case of refracture. The overall reoperation rate was 16.6%. The overall complication rate was 34.2%, and 15.9% of the patients developed skin problems. The rate of infection was 3.4%. The overall union rate was 97.9%, and nonunion occurred in one patient (0.8%). Three patients (2.2%) developed pin tract infection. The use of the external fixator was associated with a significantly lower infection rate. There was no case of deep infection or osteomyel


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