The Ilizarov Ring External Fixator in Complex Open Fractures of the Tibia

Abstract

Complex open fracture of the tibia particularly with bone defect and infection is one of the major problems in orthopedic surgery. There are many available alternatives in the management of these fractures. The purpose of this study is to evaluate the results and efficacy of the Ilizarov ring external fixator in treating complex open fractures of the tibia. We treated 25 patients with complex open fracture of the tibia using the Ilizarov ring external fixator between March 1999 and February 2002. The open fractures were type IIIA, type IIIB , and type IIIC in 19, 9, and 4 patients, respectively. There were 11 patients with bone loss ranging from 3 to 9 cm (average bone loss 5 cm), and 10 patients with infection. There were 11 one-level tibial transports, 5 bone graftings at the docking site, 6 internal fixations with bone grafting because of pin tract infection. Results were divided into bone and functional categories [according to the association for the study and application of the method of Ilizarov (ASAMI) classification]. The bony results were excellent in 18 patients (56.2%), good in 4 (12.5%), fair in 3 (9.4%), and poor in 7 (21.9 %). The functional results were excellent in 7 (21.9%) patients, good in 14 (43.7%), fair in 4 (12.5%), and poor in 7 (21.9%). The Ilizarov ring external fixator is an effective a salvage procedure in the treatment of complex open fractures of the tibia as it allows for the simultaneous treatment of bone loss, infection, non-union, and deformity.