<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0864-215X</journal-id>
<journal-title><![CDATA[Revista Cubana de Ortopedia y Traumatología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Ortop Traumatol]]></abbrev-journal-title>
<issn>0864-215X</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0864-215X2021000100004</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Caracterización de fracturas abiertas de tibia]]></article-title>
<article-title xml:lang="en"><![CDATA[Characterization of Open Tibial Fractures]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vázquez Ribas]]></surname>
<given-names><![CDATA[Ernesto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tabares Sáez]]></surname>
<given-names><![CDATA[Horacio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Morales Seife]]></surname>
<given-names><![CDATA[Roberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tabares Neyra]]></surname>
<given-names><![CDATA[Horacio Inocencio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Ciencias Médicas de La Habana Hospital Universitario General Calixto García ]]></institution>
<addr-line><![CDATA[ La Habana]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Centro de Investigaciones en Longevidad, Envejecimiento y Salud  ]]></institution>
<addr-line><![CDATA[ La Habana]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<volume>35</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0864-215X2021000100004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0864-215X2021000100004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0864-215X2021000100004&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  Las fracturas diafisiarias de la tibia son las que con mayor frecuencia encuentran los cirujanos ortopédicos en su práctica habitual. La fractura expuesta de tibia es una urgencia quirúrgica que requiere desbridamiento, lavado, reducción y estabilización de los fragmentos óseos lo antes posible, e inicio de la administración de antibióticos profilácticos.  Objetivo:  Caracterizar los pacientes con fractura expuesta de tibia grado II y IIIA, tratados mediante estabilización con clavo acerrojado intramedular, identificando mecanismo de producción, número de intervenciones quirúrgicas por paciente, así como las principales complicaciones encontradas.  Método:  Estudio observacional, descriptivo, ambispectivo y de corte transversal en pacientes con fractura abierta de tibia, tratados quirúrgicamente con clavo acerrojado intramedular.  Resultados:  La edad de los pacientes osciló entre 21 y 69 años. Predominó el sexo masculino (65,4 %), la mayor causa traumática fueron los accidentes en la vía pública (37 pacientes); predominaron las fracturas del tercio medio abiertas grado IIIA con estadía hospitalaria menor de 10 días, y complicaciones en la tercera parte de los pacientes.  Conclusiones:  Se observó mayor incidencia en pacientes masculinos en edades comprendidas entre 18 y 29 años por accidentes del tránsito. La localización habitual fue el tercio medio y más de la mitad fueron clasificadas como grado IIIA de la tipología de Gustilo y Anderson.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction: Diaphyseal fractures of the tibia are those most frequently treated by orthopedic surgeons in their common practice. The exposed fracture of the tibia is a surgical emergency that requires debridement, lavage, reduction and stabilization of the bone fragments as soon as possible, and initiation of the administration of prophylactic antibiotics.  Objective:  To characterize patients with grade II and IIIA exposed tibial fracture, treated by stabilization with an intramedullary nail, identifying production mechanism, number of surgical interventions per patient, as well as the main complications found.  Method:  An observational, descriptive, ambispective and cross-sectional study in patients with an open fracture of the tibia treated surgically with an intramedullary locking nail.  Results:  The age of the patients ranged between 21 and 69 years. Male sex predominated (65.4%), the major traumatic cause was accidents on public roads (37 patients); Grade IIIA open middle third fractures predominated with hospital stays of less than 10 days, and complications in a third of the patients.  Conclusions:  High incidence was observed in male patients between the ages of 18 and 29 due to traffic accidents. The usual location was the middle third and more than half were classified as grade IIIA of Gustilo and Anderson typology.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Fractura expuesta de tibia]]></kwd>
<kwd lng="es"><![CDATA[sexo masculino]]></kwd>
<kwd lng="es"><![CDATA[clasificación de Gustilo y Anderson]]></kwd>
<kwd lng="en"><![CDATA[Exposed fracture of the tibia]]></kwd>
<kwd lng="en"><![CDATA[male gender]]></kwd>
<kwd lng="en"><![CDATA[Gustilo and Anderson classification]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bhandari]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Gh]]></surname>
<given-names><![CDATA[Guyatt]]></given-names>
</name>
<name>
<surname><![CDATA[3rd]]></surname>
<given-names><![CDATA[Tornetta P]]></given-names>
</name>
<name>
<surname><![CDATA[Mf]]></surname>
<given-names><![CDATA[Swiontkowski]]></given-names>
</name>
<name>
<surname><![CDATA[Hanson]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Sprague]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Current practice in the intramedullary nailing of tibial shaft fractures: an international survey]]></article-title>
<source><![CDATA[J Trauma]]></source>
<year>2002</year>
<volume>53</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>725-32</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Weber]]></surname>
<given-names><![CDATA[CD]]></given-names>
</name>
<name>
<surname><![CDATA[Hildebrand]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Kobbe]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Lefering]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Sellei]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<name>
<surname><![CDATA[Pape]]></surname>
<given-names><![CDATA[HC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology of open tibia fractures in a population-based database update on current risk factors and clinical implications]]></article-title>
<source><![CDATA[Eur J Trauma Emerg Surg]]></source>
<year>2019</year>
<volume>45</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>445-53</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mundi]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Chaudhry]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Niroopan]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Petrisor]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Bhandari]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Open tibial fractures Updated guidelines for management]]></article-title>
<source><![CDATA[JBJS Rev]]></source>
<year>2015</year>
<volume>3</volume>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Young]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Aquilina]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Chesser]]></surname>
<given-names><![CDATA[TJS]]></given-names>
</name>
<name>
<surname><![CDATA[Costa]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Hettiaratchy]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Kelly]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Open tibial fractures in major trauma centers A national prospective cohort study of current practice]]></article-title>
<source><![CDATA[Injury]]></source>
<year>2019</year>
<volume>50</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>497-502</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[López Contreras]]></surname>
<given-names><![CDATA[FO]]></given-names>
</name>
<name>
<surname><![CDATA[Barrera Tobar]]></surname>
<given-names><![CDATA[FY]]></given-names>
</name>
<name>
<surname><![CDATA[Lamilla Cedeño]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Villacres Zapata]]></surname>
<given-names><![CDATA[CF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fracturas expuestas de tibia, características clínicas, complicaciones y factores de riesgo]]></article-title>
<source><![CDATA[Sinergias Educativas]]></source>
<year>2020</year>
<volume>E</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ludwig]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hymes]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Schulman]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Pitta]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Ramsey]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Intramedullary nailing of open tibial fractures Provisional plate fixation]]></article-title>
<source><![CDATA[Orthopedics]]></source>
<year>2016</year>
<volume>39</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>e931-6</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Browner]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Jupiter]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Trafton]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Levine]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Krettek]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[Skeletal trauma]]></source>
<year>2019</year>
<volume>2</volume>
<publisher-loc><![CDATA[Canadá ]]></publisher-loc>
<publisher-name><![CDATA[Saunders Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Uludag]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Tosun]]></surname>
<given-names><![CDATA[HB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Treatment of unstable pediatric tibial shaft fractures with titanium elastic nails]]></article-title>
<source><![CDATA[Medicina]]></source>
<year>2019</year>
<volume>55</volume>
<numero>266</numero>
<issue>266</issue>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pollak]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Jones]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
<name>
<surname><![CDATA[Castillo]]></surname>
<given-names><![CDATA[RC]]></given-names>
</name>
<name>
<surname><![CDATA[Bosse]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Mackenzie]]></surname>
<given-names><![CDATA[EJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The relationship between time to surgical debridement and incidence of infection after open high energy lower extremity trauma]]></article-title>
<collab>LEAP Study Group</collab>
<source><![CDATA[J Bone Joint Surg]]></source>
<year>2010</year>
<volume>92</volume>
<page-range>7-15</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hohmann]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Tetsworth]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Radziejowski]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Wiesnieswski]]></surname>
<given-names><![CDATA[TF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comparison of delayed and primary wound closure in the treatment of open tibial fractures]]></article-title>
<source><![CDATA[Arch Orthop Trauma Surg]]></source>
<year>2007</year>
<volume>127</volume>
<page-range>131-6</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ruedi]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Murphy]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<source><![CDATA[Principios de la AO en el tratamiento de las fracturas]]></source>
<year>2017</year>
<publisher-loc><![CDATA[Barcelona, España ]]></publisher-loc>
<publisher-name><![CDATA[Masson]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Craveiro Lopes]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Treatment of open fractures of the tibia with a locked intramedullary nail with a core release of antibiotics (SAFE Dual Core Universal) Comparative study with a standard locked intramedullary nail]]></article-title>
<source><![CDATA[J Limb Lengthen Reconstr]]></source>
<year>2016</year>
<volume>2</volume>
<page-range>17-22</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lua]]></surname>
<given-names><![CDATA[JYC]]></given-names>
</name>
<name>
<surname><![CDATA[Tan]]></surname>
<given-names><![CDATA[VH]]></given-names>
</name>
<name>
<surname><![CDATA[Sivasubramanian]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Kwek]]></surname>
<given-names><![CDATA[EBK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Complications of open tibial fracture management Risk factors and treatment]]></article-title>
<source><![CDATA[Malaysian Orthopaedic Journal]]></source>
<year>2017</year>
<volume>11</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>18-22</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chitnis]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
<name>
<surname><![CDATA[Vanderkarr]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Sparks]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[McGlohorn]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Holy]]></surname>
<given-names><![CDATA[CE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Complications and its impact in patients with closed and open tibial shaft fractures requiring open reduction and internal fixation]]></article-title>
<source><![CDATA[J Comp Eff Res]]></source>
<year>2019</year>
<volume>8</volume>
<numero>16</numero>
<issue>16</issue>
<page-range>1405-16</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Herrera Jaramillo]]></surname>
<given-names><![CDATA[VS]]></given-names>
</name>
<name>
<surname><![CDATA[Zavala Villavicencio]]></surname>
<given-names><![CDATA[KJ]]></given-names>
</name>
</person-group>
<source><![CDATA[Manejo inicial de fracturas expuestas de diáfisis de tibia en el "Hospital de Especialidades Teodoro Maldonado Carbó" durante el periodo de enero 2015 a diciembre 2017]]></source>
<year>2018</year>
<publisher-loc><![CDATA[Guayas, Ecuador ]]></publisher-loc>
<publisher-name><![CDATA[Universidad de Guayaquil]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Saied]]></surname>
<given-names><![CDATA[HZ]]></given-names>
</name>
<name>
<surname><![CDATA[Mahmoud]]></surname>
<given-names><![CDATA[WS]]></given-names>
</name>
<name>
<surname><![CDATA[Arafa]]></surname>
<given-names><![CDATA[KS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Treatment of open comminuted diaphyseal fracture of the tibia by Ilizarov]]></article-title>
<source><![CDATA[The Egyptian Journal of Hospital Medicine (EJHM)]]></source>
<year>2019</year>
<volume>77</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>5965-72</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Bai]]></surname>
<given-names><![CDATA[BL]]></given-names>
</name>
<name>
<surname><![CDATA[Boodhun]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[ZY]]></given-names>
</name>
<name>
<surname><![CDATA[Xie]]></surname>
<given-names><![CDATA[ZJ]]></given-names>
</name>
<name>
<surname><![CDATA[Feng]]></surname>
<given-names><![CDATA[ZH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Treatment of segmental tibial shaft fractures combination of external fixator with titanium elastic nails versus locking intramedullary nail]]></article-title>
<source><![CDATA[Int J Clin Exp Med]]></source>
<year>2018</year>
<volume>11</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>2867-76</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Collinge]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Beltran]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Dollahite]]></surname>
<given-names><![CDATA[HA]]></given-names>
</name>
<name>
<surname><![CDATA[Huber]]></surname>
<given-names><![CDATA[FG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Percutaneous clamping of spiral and oblique fractures of the tibial shaft a safe and effective reduction aid during intramedullary nailing]]></article-title>
<source><![CDATA[J Orthop Trauma]]></source>
<year>2015</year>
<volume>29</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>e208-12</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gill]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Early conversion of external fixation to interlocked nailing in open fractures of both bone leg assisted with vacuum closure (VAC)- final outcome]]></article-title>
<source><![CDATA[J Clin Diagn Res]]></source>
<year>2016</year>
<volume>10</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>Rc10-4</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jiménez Ordoñez]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
</person-group>
<source><![CDATA[Prevalencia y factores de riesgo asociados a fracturas expuestas de tibia en el área de Cirugía del Hospital General de Macas en el periodo de enero de 2012 a diciembre de 2016]]></source>
<year>2017</year>
<publisher-loc><![CDATA[Cuenca, Ecuador ]]></publisher-loc>
<publisher-name><![CDATA[Universidad Católica de Cuenca]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jaña Neto]]></surname>
<given-names><![CDATA[FC]]></given-names>
</name>
<name>
<surname><![CDATA[Canal]]></surname>
<given-names><![CDATA[MP]]></given-names>
</name>
<name>
<surname><![CDATA[Fonseca Alves]]></surname>
<given-names><![CDATA[BA]]></given-names>
</name>
<name>
<surname><![CDATA[Martins Ferreira]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Castro Ayres]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Alves]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Analysis of the characteristics of patients with open tibial fractures of Gustilo and Anderson type III]]></article-title>
<source><![CDATA[Rev Bras Ortop]]></source>
<year>2016</year>
<volume>51</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>143-9</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Xu]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Ren]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Ma]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Lu]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical characteristics and economic analysis of intramedullary nailing versus plate and screws for open distal tibial fractures: A retrospective study]]></article-title>
<source><![CDATA[Research Square]]></source>
<year>2018</year>
</nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Haonga]]></surname>
<given-names><![CDATA[BT]]></given-names>
</name>
<name>
<surname><![CDATA[Areu]]></surname>
<given-names><![CDATA[MMM]]></given-names>
</name>
<name>
<surname><![CDATA[Challa]]></surname>
<given-names><![CDATA[ST]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
<name>
<surname><![CDATA[Elieza]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Morshed]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Early treatment of open diaphyseal tibia fracture with intramedullary nail versus external fixator in Tanzania: Cost effectiveness analysis using preliminary data from Muhimbili Orthopaedic Institute]]></article-title>
<source><![CDATA[SICOT-J]]></source>
<year>2019</year>
<volume>5</volume>
<numero>20</numero>
<issue>20</issue>
</nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ma]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
<name>
<surname><![CDATA[Jiang]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Tu]]></surname>
<given-names><![CDATA[YK]]></given-names>
</name>
<name>
<surname><![CDATA[Lin]]></surname>
<given-names><![CDATA[TS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Metaphyseal locking plate as an external fixator for open tibial fracture: Clinical outcomes and biomechanical assessment]]></article-title>
<source><![CDATA[Injury]]></source>
<year>2016</year>
</nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lua]]></surname>
<given-names><![CDATA[JYC]]></given-names>
</name>
<name>
<surname><![CDATA[Tan]]></surname>
<given-names><![CDATA[VH]]></given-names>
</name>
<name>
<surname><![CDATA[Sivasubramanian]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Kwek]]></surname>
<given-names><![CDATA[EBK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Complications of open tibial fracture management Risk factors and treatment]]></article-title>
<source><![CDATA[Malaysian Orthopaedic Journal]]></source>
<year>2017</year>
<volume>11</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>18-22</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zumba Castillo]]></surname>
<given-names><![CDATA[YF]]></given-names>
</name>
</person-group>
<source><![CDATA[Manejo quirúrgico de fracturas de tibia por accidente de tránsito atendidas en el Hospital Isidro Ayora de Loja]]></source>
<year>2017</year>
<publisher-loc><![CDATA[Loja, Ecuador ]]></publisher-loc>
<publisher-name><![CDATA[Universidad Nacional de Loja]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pennock]]></surname>
<given-names><![CDATA[AT]]></given-names>
</name>
<name>
<surname><![CDATA[Bastrom]]></surname>
<given-names><![CDATA[TP]]></given-names>
</name>
<name>
<surname><![CDATA[Upasani]]></surname>
<given-names><![CDATA[VV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Elastic intramedullary nailing versus open reduction internal fixation of pediatric tibial shaft fractures]]></article-title>
<source><![CDATA[J Pediatr Orthop]]></source>
<year>2017</year>
</nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Golubovic]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Ristic]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Stojiljkovic]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Ciric]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Golubovic]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Radovanovic]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Results of open tibial fracture treatment using external fixation]]></article-title>
<source><![CDATA[Srp Arh Celok Lek]]></source>
<year>2016</year>
<volume>144</volume>
<numero>5-6</numero>
<issue>5-6</issue>
<page-range>293-9</page-range></nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lack]]></surname>
<given-names><![CDATA[WD]]></given-names>
</name>
<name>
<surname><![CDATA[Karunakar]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Angerame]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Seymour]]></surname>
<given-names><![CDATA[RB]]></given-names>
</name>
<name>
<surname><![CDATA[Sims]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Kellam]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Type III open tibia fractures immediate antibiotic prophylaxis minimizes infection]]></article-title>
<source><![CDATA[Journal of Orthopaedic Trauma]]></source>
<year>2015</year>
<volume>29</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>1-6</page-range></nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kwasnicki]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<name>
<surname><![CDATA[Hettiaratchy]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Okogbaa]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Lo]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Yang]]></surname>
<given-names><![CDATA[GZ]]></given-names>
</name>
<name>
<surname><![CDATA[Darzi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Return of functional mobility after an open tibial fracture a sensor-based longitudinal cohort study using the Hamlyn Mobility Score]]></article-title>
<source><![CDATA[Bone Joint J]]></source>
<year>2015</year>
<volume>97B</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>1118-25</page-range></nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Núñez Célis]]></surname>
<given-names><![CDATA[HH]]></given-names>
</name>
</person-group>
<source><![CDATA[Evaluación de fractura diafisiaria de tibia según sus características socio-demográficas y clínicas en pacientes atendidos en el Hospital Iquitos en el periodo de enero 2013 a diciembre 2014]]></source>
<year>2015</year>
<publisher-loc><![CDATA[Iquitos, Perú ]]></publisher-loc>
<publisher-name><![CDATA[Universidad Nacional de la Amazonia Peruana]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Galal]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Minimally invasive plate osteosynthesis has equal safety to reamed intramedullary nails in treating Gustilo-Anderson type I, II and III-A open tibial shaft fractures]]></article-title>
<source><![CDATA[Injury]]></source>
<year>2018</year>
<volume>49</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>866-70</page-range></nlm-citation>
</ref>
<ref id="B33">
<label>33</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Abdel-Aal]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fractures of the proximal third tibia treated with intramedullary interlocking nails and blocking screws]]></article-title>
<source><![CDATA[Ortho &amp; Rheum Open Access J]]></source>
<year>2016</year>
<volume>2</volume>
<numero>4</numero>
<issue>4</issue>
</nlm-citation>
</ref>
<ref id="B34">
<label>34</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Metsemakers]]></surname>
<given-names><![CDATA[WJ]]></given-names>
</name>
<name>
<surname><![CDATA[Morgenstern]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[McNally]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fracture-related infection a consensus on definition from an international expert group]]></article-title>
<source><![CDATA[Injury]]></source>
<year>2018</year>
<volume>49</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>505-10</page-range></nlm-citation>
</ref>
<ref id="B35">
<label>35</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Camporro Fernández]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Ontaneda Rubio]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Castellanos Morán]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tratamiento de fracturas abiertas de tibia grado IIIB-IIIC de Gustilo con colgajos libres microvascularizados]]></article-title>
<source><![CDATA[Cir Plást Iberolatinoam]]></source>
<year>2015</year>
<volume>41</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>283-93</page-range></nlm-citation>
</ref>
<ref id="B36">
<label>36</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Acharya]]></surname>
<given-names><![CDATA[BM]]></given-names>
</name>
<name>
<surname><![CDATA[Tamrakar]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Devkota]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Thakur]]></surname>
<given-names><![CDATA[AK]]></given-names>
</name>
<name>
<surname><![CDATA[Shrestha]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Outcome of tibial diaphyseal fracture fixation with Surgical Implant Generation Network (SIGN) nail]]></article-title>
<source><![CDATA[Journal of Patan Academy of Health Sciences]]></source>
<year>2019</year>
<volume>6</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>5-11</page-range></nlm-citation>
</ref>
<ref id="B37">
<label>37</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gutiérrez Blanco]]></surname>
<given-names><![CDATA[MO]]></given-names>
</name>
</person-group>
<source><![CDATA[Estimulación electromagnética asociada a los fijadores externos en el tratamiento de las fracturas abiertas de tibia]]></source>
<year>2010</year>
<publisher-loc><![CDATA[Camagüey, Cuba ]]></publisher-loc>
<publisher-name><![CDATA[Universidad de Ciencias Médicas de las FAR]]></publisher-name>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
