Abstract
Objective: This study was designed to evaluate the effectiveness of Ilizarov. We aimed to explore the infection rate, bony union, and functional outcomes of Ilizarov fixators.
 Methodology: This retrospective study was conducted in Orthopedic department of Bolan Medical Complex Hospital Quetta Pakistan from June 2020 to June 2021. In this timeframe total of fifty-five patients of infected nonunion tibia were enrolled for Ilizarov technique treatment. For surgical intervention, patients were placed in a supine position on a radiolucent table. Ilizarov fixator was prepared on the behalf of patient's limb length, infection site, and ankle and knee functional status. We applied assembled Ilizarov fixator at the tibial shaft while keeping in mind that the rings were positioned in on the proximal and distal fragments. The ring was placed parallel to the joints whereas pins were inserted perpendicular to the tibial mechanical axis.
 Results: A total of 55 patients were recruited for this study. The mean age of the selected participants was 45.65±16.69 years. The overall successful bone results of the ASAMI score were observed as 80% whereas 88% functional outcomes were achieved. In bone results, we observed 28 (50.9%) cases with excellent results, 16 (29%) with good, 7 (12.7%) with fair, and 3 (5.4%) with poor outcomes. On the other hand, 25 (45.4%) cases observed excellent functional results, 25 (45.4%) with good, 4 (7.6%) with fair, and 2 (3.6%) with poor outcomes.
 Conclusion: Our results show a high success ratio therefore we recommend Ilizarov external fixators for infected nonunion tibial fracture. This method helps to recover limbs without any amputations. However, the discomfort of patients is one of the main problems with this method of treatment.
Highlights
Due to the increasing number of trauma high ratio of incidence related to long bone was reported in recent years [1]
A large variety of nonunion bony defect treatment is introduced still the management of nonunion bony defects is a challenging problem for many orthopedic surgeons [4]
We aimed to explore the infection rate, bony union, and functional outcomes of Ilizarov fixators
Summary
Due to the increasing number of trauma high ratio of incidence related to long bone was reported in recent years [1] Among these complex and compound fractures of a long bone, the tibia is most persistent due to its vulnerable subcutaneous location. Methods like soft-tissue rotational flaps, antibiotic cement beading, bone grafting, bone transplants, and Ilizarov are available for managing chronic diaphyseal infections associated with non-union [5]. Regardless of these methods, the Ilizarov fixator provides better outcomes for managing nonunion defects >4cm [6]. This method has an advantage over others in terms of compensation of bony defects, infection elimination, and achieved bony union through histogenesis [7]
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