{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:00:07Z","timestamp":1764331207308,"version":"3.46.0"},"reference-count":23,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Open tibial shaft fractures are severe injuries associated with high risks of infection and malunion. Although external fixation is commonly used for provisional stabilization, it provides limited control over alignment and soft tissue handling. This study aimed to evaluate and compare provisional reduction plating with external fixation for the staged management of Gustilo\u2013Anderson type II\u2013III open tibial fractures. Methods: Fifty-nine patients (mean age, 38.5 years) treated with staged debridement and delayed intramedullary nailing (IMN) were retrospectively reviewed. Thirty-two patients underwent reduction plating with external fixation (group A), and 27 underwent external fixation alone (group B). Clinical, radiographic, and functional outcomes, including infection, union, malunion, operative time, and Lower Extremity Functional Scale (LEFS) scores, were analyzed. Results: Deep infection and nonunion rates were comparable between the groups. Group A had fewer malunions (3.1% vs. 18.5%), shorter operative times, and faster progression to union than group B. The LEFS scores were higher in group A, indicating better functional recovery. Conclusions: Provisional reduction plating before IMN appears to enhance alignment, preserve soft tissue integrity, and improve surgical efficiency without increasing the risk of infection or delaying union. These findings suggest that it may be a safe and effective adjunct to the staged treatment of complex Gustilo\u2013Anderson type II\u2013III open tibial fractures.<\/jats:p>","DOI":"10.3390\/jcm14238421","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T11:19:51Z","timestamp":1764328791000},"page":"8421","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Provisional Reduction Plating Versus External Fixation in the Staged Management of Gustilo\u2013Anderson Type II\u2013III Open Tibial Shaft Fractures"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4137-0764","authenticated-orcid":false,"given":"Yong-Cheol","family":"Yoon","sequence":"first","affiliation":[{"name":"Orthopedic Trauma Division, Trauma Center, Gachon University College of Medicine, 21 Namdong-daero, 774 Beon-gil, Namdong-gu, Incheon 21565, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seok Hwan","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Gachon University College of Medicine, 21 Namdong-daero, 774 Beon-gil, Namdong-gu, Incheon 21565, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3921-719X","authenticated-orcid":false,"given":"Min Jun","family":"Kim","sequence":"additional","affiliation":[{"name":"Orthopedic Trauma Division, Trauma Center, Gachon University College of Medicine, 21 Namdong-daero, 774 Beon-gil, Namdong-gu, Incheon 21565, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyoung-Keun","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Gyeonggi-do, Goyang-si 10380, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.2106\/JBJS.RVW.N.00051","article-title":"Open tibial fractures: Updated guidelines for management","volume":"3","author":"Mundi","year":"2015","journal-title":"JBJS Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1302\/0301-620X.83B1.0830062","article-title":"Treatment of open fractures of the shaft of the tibia","volume":"83","author":"Bhandari","year":"2001","journal-title":"J. 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