Treatment of Post Traumatic Femoral Bone Loss Using Ilizarov External Fixator; Technical difficulties and complications analysing approach.

Abstract

Purpose Internal bone transport using Ilizarov external fixator for management of post traumatic femoral bone loss is a technically demanding procedure that entails many surgical difficulties. Many complications were encountered either intra or post operative. Proper and early management of these complications markedly improves the overall results. Methods In the period from January 2011to June 2013, 17 cases of post traumatic femoral bone loss were treated with bone transport using Ilizarov external fixator. All fractures were open, 15 cases were grade IIIb and two cases were grade IIIc according to Gustillo – Anderson classification. The cases included in this study had bone defect more than four cm. The defect was diaphyseal in five cases and metaphyseal diaphyseal in 12 cases with distal intra articular extension in two cases. This procedure was lengthy; to reduce the time of the procedure, all cases were managed either by acute collapse at the fracture site and subsequent limb lengthening or partial collapse of the defect and limb lengthening to achieve limb length equality. Results In all cases the bone continuity was restored with complete union of the fracture. The complication rate was high but all of them could be dealt with successfully. According to ASAMI scoring system the bone results were higher than functional results in all cases. Conclusion This method was proved to be effective in restoring the skeletal integrity inspite of many complications recorded.