Efficacy of Hybrid Ilizarov fixation in reducing time span of union in infected non-union of tibia

Author(s): Dr. Yogesh R Gaikwad MS, Dr. Vijay Vasant Nemade DNB, Dr. Tushar Jibhau Deore DNB and Dr. Prashant Vilas Bhandari DNB

Abstract: Background: Ilizarov external fixator is the modality of choice for treatment of infected non-union of tibial shaft fractures. The time duration for which the Ilizarov fixator is required to be kept (the Fixator index) is long with this method, is cumbersome for the patient, and associated with complications. Hybrid Ilizarov fixation by adding one Schanz screw in each ring along with two tensioned transosseous wires has many advantages such as reduced complications, reduced surgical time, more stable fixation, early mobilization, early union and reduced span of fixation. Aim of this study is to compare the results of Hybrid Ilizarov fixation and Ilizarov fixation in treating infected tibial non-unions. Materials and methods: This study involved retrospective evaluation of 42 patients of infected non-union of tibia treated at our institute between August2007 to December 2013. Initially for first two years we treated 19 patients of infected non-union of tibia with Ilizarov fixation, later since August 2009 we started treating patients with Hybrid Ilizarov fixation. We used 5.5mm Schanz screw inserted anteromedially in each ring along with two tensioned transosseous wires. Total 23 patients of infected non-union tibia were treated with Hybrid Ilizarov fixation. Results: Patients treated with Ilizarov fixation initially from August 2007 to July 2009 were labelled as Group A. From August 2009 to December 2013 we treated patients with Hybrid Ilizarov fixation and they were labelled as Group B. Good consolidation was seen on radiographs after a mean period of 6.2 months in Group A patients and 5.8 months in Group B patients, hence accordingly the Fixator index was reduced in Group B patients. Overall complication rate was reduced in Group B patients and functional outcome was better in Group B patients. Conclusion: Our results demonstrated better outcome with Hybrid Ilizarov fixator in treating infected non-union of tibia shaft fractures.