Use Of Ilizarov External Fixator Research Articles

Ilizarov External Fixator Versus Orthofix LRS in Management of Femoral Osteomyelitis: A Propensity Score Matched Analysis.

Treatment of osteomyelitis (OM) is challenging. Ilizarov bone transport is a commonly used technique for management of OM. The recently introducedlimb reconstruction system (LRS) has been effectively used for management of OM. It was suggested to be easier in use and less invasive. The present retrospective study aimed to compare LRS and Ilizarov bone transport in management of femoral OM using a propensity score matched analysis. The present retrospective study included 80 consecutive patients with femoral OM. The studied patients were managed either using Ilizarov external fixator (n = 40) or Orthofix LRS (n = 40). The clinical outcome measurements included union time, limb length discrepancy, additional operative procedures, refracture and infection. Patients in the LRS group were exposed to significantly higher frequency of bone transport (30.0 versus 15.0%) and lower frequency of acute compression and lengthening (10.0 versus 32.5%). Patients in Ilizarov group had significantly higher frequency of tobramycin pellets as compared to their counterparts. The studied groups were comparable regarding the operative complications including pin-tract infection, non-union at docking site and refracture. Patients in the Ilizarov had significantly shorter time to union (8.2 ± 3.2 versus 11.0 ± 5.6 months, p = 0.012). No statistically significant differences were found between the studied groups regarding the quality-of-life domains. Use of Ilizarov external fixator and Orthofix LRS devices proved to be effective and reliable. Their influences on patients' quality appear to be comparable.

Functional outcome analysis of ilizarov ring fixator as definitive fixation of open tibial fractures

: Ilizarov fixator for open tibia fractures permits axial micro mobility at fracture site to encourage bone regrowth. Literature search revealed dearth of studies from Indian centres which have evaluated its utility in open tibia fractures. : This was an observational prospective study conducted by Department of Orthopaedics at VVPF Medical College, Ahmednagar in Maharashtra, between July 2021 to June 2022. All patients who had open tibia fractures and managed by Ilizarov ring fixator were included. Duration of treatment with fixator was evaluated, along with range of motion at knee and ankle, union status and complications.: 30 patients were enrolled, majority being males (n=22, 73.33%). Most patients suffered from fractures of right side (n=21, 70%) confined to metaphyseal region (n=16, 53.33%). Commonest mode of injury was road traffic accidents (n=26, 86.67%). Based on Gustilo-Anderson classification, majority cases were grade IIIA (n=16, 53.33%). 23 cases (76.67%) were managed initially with external fixators, while 7 cases were directly managed with Ilizarov ring fixator. Most cases (n=15, 50%) received definitive fixation on day-3 of injury. Commonest complication noted was pin site infection (n=11, 36.67%) and delayed union (n=4, 13.33%). Knee stiffness at 30was noted in 3 cases, corrected by physiotherapy. All patients attained fracture union, with the earliest evidence of radiological union observed after 2 months of surgery. : As it allows for early full weight bearing mobilisation, has higher union rates and lesser incidences of malunion, use of Ilizarov external fixator maintains its importance in the management of open tibial fractures.

The use of ilizarov external fixator for open comminuted fractures in different parts of tibia

<p><strong>Background:</strong> Open fracture of tibia is a common occurrence in the orthopedic treatment arena. Ilizarov technique is a popular technique of treating open tibial fracture after debridement and open reduction. It is comparatively a newer method and has many advantages.</p><p><strong>Methods:</strong> This study was carried out in the department of orthopaedics, Centre for women and child health, Ashulia, Dhaka, Bangladesh during the period from January 2019 to June 2021. In total 30 patients with tibial fractures were selected as the study population. Before starting the intervention, the written consent of the participants was taken and this study was approved by the ethical committee of the respective medical college.</p><p><strong>Results:</strong> Out of total 30 participants, 24 (80%) were males and 6 (30%) were female. In analyzing mode of injuries, we found highest (86.7%) participants were from road accidents followed by 10% from sports injury and the remaining 3.3% from general falls. The duration of treatment with the fixator was 12-23 weeks (average 16 weeks). Fourteen patients wore a PTB cast for an additional period of 4 weeks. In our study total 30 cases were debrided on the same day and stabilized with Ilizarov ring fixator after a period of 5 to 12 days from the date of injury. The operation time ranged from 90 minutes to 120 minutes (Mean 102±4 minutes).</p><p><strong>Conclusions:</strong> No case developed deep infection, non-union or unacceptable mal-union. The construct is stable and enables the patient to bear weight on the affected limb a short time after the surgery, even in cases of comminuted fractures. <em></em></p>

Treatment of Tibial Plateau Fractures By Circular External Fixator

Background: Tibial plateau fracture is challenging for orthopaedic surgeons because of the severity of trauma and associated soft tissue injuries. The treatment goals are to anatomically reconstruct the proximal tibial articular surface, restore limb axial alignment, and fix metadiaphyseal comminution to allow early knee mobilization and weight bearing.Aim: To evaluate the functional, clinical and radiological outcomes of treatment of high energy tibial plateau fractures by circular external fixator ± percutaneous screw fixation.Patients and Methods: Between June 2018 and July 2019, 20 tibial plateau fractures in 20 patients were treated with Ilizarov external fixator in Benha University hospital. The mean age was 39 years (range 22–55 years), and the mean follow-up period was 11±2 months (range 8–12 months). Closed reduction was performed by closed means in 70% of cases or through minimal incisions in 30% of cases. Clinical and functional evaluation of patients in the tibial plateau group was performed.Results: All patients started weight bearing the day after the surgery. Functionally, 70% had an excellent result, 20% had a good result. Radiologically 75% of had excellent results. Pin tract infection was controlled in all patients without need to implant removal.Conclusion: The degree of soft tissue injury associated with tibial plateau fracture is an important determinant for both the choice of the treatment modality and the prediction of treatment outcome. The use of Ilizarov external fixator is safe and effective option for the treatment of difficult Schatzker IV, V and VI tibial plateau fractures.

Evaluation of the functional outcome in open tibial fractures managed with an Ilizarov fixator as a primary and definitive treatment modality

Introduction: Open fractures are rapidly compounding problem for trauma surgeons. Open fractures of leg, which are perhaps the most common among open fracture, were taken as prototype in which extra articular fracture of tibia and fibula were taken. The key components of approach were aggressive debridement; primary Ilizarov fixation and soft tissue coverage. The study was undertaken to see if the patient can be treated with single surgery of primary external fixation with Ilizarov technique so as to reduce hospitalization stay and early return to work. Material and Methods: In the present study, twenty patients with open fracture tibia were operated with Ilizarov over period of two years and the results were analyzed. Results: 25%(5) had excellent, 45%(9) had good, 30%(6) had fair result based on bone score and 30%(6) had excellent, 55%(11) had good, 5%(1) had fair and 10%(2) had poor result based on functional score.Conclusion: Compound fracture of the leg can be effectively managed with use of ilizarov external fixator as a single staged procedure.

Surgical Treatment of Children’s Genu Varum: A Comparison between Two Methods

Introduction: The Genu Varum is physiological from birth till the age of two. It is a reel consultation reason for parents who are often worried seeing this deformation that could cause gait disturbances. Materials and methods: We conducted a retrospective study over a period of 5 years on 50 patients who went through a rickety genu varum surgery. The patients were divided into two groups: Group 1 (correction of the varus by osteotomy and fixation by Blount staples and long leg cast), Group 2 (progressive correction of the varus by the Ilizarov external fixator). The purpose of this study was to compare the results of the two surgical methods. Results: The average age was 6.66 years, with ages ranging from 2 to 15 years. Females accounted for 65% and males 35%, a gender ratio of 1.23. For Group 1 (osteotomy and internal fixation by stapling associated with plaster), the average hospital stay was 22 days (range: 12-50 days). Five cases of hypo-correction and two cases of hypercorrection were recorded. However, we have observed no case of infection and no compression of the plaster under member segment. The plaster was removed within an average of seven (7) weeks. For Group 2 (Ilizarov correction) the average hospital stay was 9 days (range: 10-18 days). The correction by the external IIizarov fixator started on postoperative D2. After the hospitalization, the parents continued the correction. There were no complication or hypo-correction recorded in the Group 2. Discussion: The use of Ilizarov external fixator (progressive correction) did not disrupt the normal process of education of the child because of the reduction in the duration of hospitalization; the child may therefore continue to attend school with the fixative Ilizarov. Conclusion: Surgical correction by osteotomy of genu varum of rickety origin can prevent discomfort and possibly progressive evolution towards knee osteoarthritis later in life.

A New External Fixator Design for Femoral Fracture Reduction

Objective: To design an external fixator for femoral fracture reduction with improved angulation and adjustability, reduced bulk, and comparative stiffness. Background: The use of external fixator for femoral shaft fixators in children has been a device of choice. The use though satisfactory, the occurrences of wire∕pin tract infections has been widely reported. Moreover, The use of Ilizarov external fixator in adults has been limited due to its bulk. Hence there is a need for improvement on the current external fixators for femoral fractures. Methods: The finite element models of four-ring Ilizarov and hybrid two-ring fixators were developed. These designs were improved upon by incorporating a “modular sliding joint design,” and by reducing the bulk by reducing the number of rings and adding guide plates. Wire length optimization feature was also added in the design. Axial stiffness of the new design was compared with the hybrid design using finite element analysis (FEA). Results and Discussion: The new design has reduced bulk at the proximal region allowing its application in adults. The axial stiffness of the proposed design was found to be comparable with the two-ring hybrid design, as determined from FEA. Sliding joint design allows reduced inventory, quick assembly, and improved angulation over current designs. Wire length optimization may reduce the occurrences of wire tract infections.

Ilizarov external fixator for open fractures of the tibial shaft.

Between December 1993 and 1999 we treated 34 open tibial diaphyseal fractures. Thirty patients were available for evaluation with a mean follow-up after fracture union of 40.5 (24-80) months. Patient average age was 33.1 (15-71) years. Two fractures were grade I, 16 grade II, six grade IIIA, five grade IIIB and one grade IIIC. The wound was debrided and the bone fixed with Ilizarov device. Soft-tissue healing was achieved through Z-plasty, delayed primary closure, split-thickness skin grafting, pedicle flaps and skin traction, and all fractures united with an average 5.6 (3-15.4) months. In 28 patients the results were excellent and good, in one fair and in one poor. Despite numerous complications the use of Ilizarov external fixator provides initial and definitive fracture stability.