Document Detail


Role of early Ilizarov ring fixator in the definitive management of type II, IIIA and IIIB open tibial shaft fractures.
MedLine Citation:
PMID:  20445978     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We evaluated the results of patients with Gustilo types II, IIIA and IIIB open tibial fractures managed early with the Ilizarov external fixator (IEF). Sixty patients (51 males, nine females; age range 20-62 years; mean age 32.8 years) with type II (11 patients), type IIIA (13) and type IIIB (36) tibial diaphyseal fractures underwent emergency debridement and minimal bone fixation (with external fixator), followed by definite fixation with the IEF after three to five days. Average duration of the hospital stay was 8.6 days. All fractures united with an average union time of 21.1 weeks (standard deviation [SD] 3.18) in type II, 21.7 weeks (SD 3.57) in IIIA and 24. 9 weeks (SD 5.14) in IIIB fractures. The difference between union time in type II and IIIA was not significant (p > 0.05), but that between IIIA (and also type II) and IIIB was significant (p < 0.05). The healing index in patients who underwent lengthening was 1.5 months/cm. The wounds in 27 patients were managed by delayed primary closure, in 19 patients with second intent (all IIIB), in 11 patients with skin grafting (mostly type IIIB fractures) and in three patients with musculocutaneous flaps. The most common complications of the procedure were pin tract infection and pain at the fracture site. Most of the patients were able to achieve good knee and ankle range of motion. Early application of the Ilizarov fixator constitutes an excellent management of open tibial fractures, especially types II, IIIA and IIIB, due to good functional and radiological results. Despite the technical difficulties and some complications (which are mostly minor) IEF may be the preferred method in open tibial fractures, especially types II and III.
Authors:
Naveed Wani; Asif Baba; Khurshid Kangoo; Mohammad Mir
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-05-06
Journal Detail:
Title:  International orthopaedics     Volume:  35     ISSN:  1432-5195     ISO Abbreviation:  Int Orthop     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-31     Completed Date:  2011-09-22     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  7705431     Medline TA:  Int Orthop     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  915-23     Citation Subset:  IM    
Affiliation:
Department of Orthopedics, Government Medical College, Srinagar, India.
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MeSH Terms
Descriptor/Qualifier:
Adult
External Fixators
Female
Fracture Healing
Fractures, Open / pathology,  radiography,  surgery*
Humans
Ilizarov Technique*
Injury Severity Score
Male
Middle Aged
Postoperative Complications
Prospective Studies
Range of Motion, Articular
Tibial Fractures / pathology,  radiography,  surgery*
Treatment Outcome
Young Adult
Comments/Corrections

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