Disability Adjusted Life Year (DALY) loss in open tibia fracture treated with External vs Internal fixation

Abstract

Background: Tibial fractures are the most prevalent long bone fractures, with around a quarter of them being open. Due
to the tibial shaft’s lack of soft tissue covering and blood flow, managing these fractures can be difficult. The degree of
initial bone displacement, comminution, and soft tissue injuries all influence the prognosis.
Objectives: To compare the loss of DALY in open tibia fracture patients treated with external versus internal fixation.
Methods: 50 patients with open tibia fractures – 25 patients treated with external fixation and 25 patients with internal
fixation. On admission, demographic information was collected, and a comprehensive history was conducted to determine
the mode of injury and any co-morbidities. To examine other connected injuries and open wounds, a general systemic
and local examination was performed, followed by radiological evaluation in AP and Lateral views. After the diagnosis
has been established, the patient was informed of the fracture and the necessity for surgery. The consent is obtained, and
pre-operative planning is done. The mean DALY was calculated based on the union of fracture.
Results: External fixation resulted in an average DALY loss of 8.40 months, while internal fixation resulted in a DALY loss
of 4.9 months. When compared to External Fixation, Internal Fixation clinical union occurs in a significantly shorter time.
Conclusion: The outcome of the study shows that Internal fixation outperformed External fixation in terms of DALY loss,
with External fixation losing considerably more DALYs than Internal fixation.