A prospective study of the effectiveness of Ilizarov ring fixator in the surgical treatment of tibial fracture infective none: Unions in adults

Author(s): Dr. Muralidharan R and Dr. Venkatachalam K

Abstract: Infective non-unions of the tibia are a surgical challenge because of their compromised bone vascularity and are prone to limb shortening when treated by conventional methods. In this prospective case series done between January 2016 to December 2018, we treated 21 patients, reporting with infective non-union of the tibia by the application of Ilizarov external ring fixator. Surgical management of infective non-unions has drastically changed in the last two decades. The ring fixation device offers acute docking of the fracture non-union site and maintains compression, meanwhile any shortening that might have occurred due to either towards loss of comminuted fracture fragments or that lost during freshening of fracture non-union site can be addressed simultaneously, by doing a corticotomy and bone transport simultaneously as the non-unions progresses successfully to union. An additional benefit of the ring fixation device used to treat these non-unions is that patients can resume ambulatory status as early as within two weeks, from the date of surgery and can remain ambulant throughout the treatment time. The consolidation time in our series was anywhere between 9 months to 14 months, depending upon the length of transport that was needed to compensate for limb shortening. All 21 cases went on to successful union. We had 42.86% of minor complications and 18.98 % of major complications. As per the ASAMI grading, we had 52.5% excellent, 25.5% good, 17% fair and 5% of poor grading in our series, by averaging the bony and functional results. Hence our study concluded that the Ilizarov external ring fixator system is a versatile tool to surgically address infective tibial non- unions with or without bone length shortening.

DOI: https://doi.org/10.22271/ortho.2019.v5.i3g.1565