Vol. 10, Issue 4 (2024)

Background: The distal femur fractures constitute about 4-6% of all femoral fractures and generally occur due to high-energy trauma. These injuries remain some of the clinically most challenging because of their associated morbidity, chronic pain, and complications associated with conventional surgical techniques-namely, nonunion and malunion. Distraction osteogenesis, as described by Gavriil Ilizarov in the 1950s through his Ilizarov external fixation technique, offers a good option in the management of complex fractures with the aim of stabilizing the fracture while preserving the biological environment.

The aim of this study: Was to review the clinical results after Ilizarov external fixation in patients presenting with distal femoral fractures, specifically in terms of healing time for fractures, functional recovery, and complication rates.

Methods: In this retrospective cohort study, 42 patients with distal femoral fractures who underwent Ilizarov external fixation were studied at Department of Orthopaedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Sher-e-Bangla Nagar, Dhaka, Bangladesh. from January 2023 to December 2023. Demographics data regarding fracture characteristics and healing time were recorded. Further functional measurements regarding functional outcomes were assessed by Knee Society Score (KSS) and Short Form-36 (SF-36) health survey. Measured outcomes included paired t-tests, chi-square tests, and Pearson correlation coefficients.

Results: The average age of the patients was 38 years, with 60% being males. The average period of time to bony union was 14 weeks; the range was from 10 to 20 weeks, with 81% achieving union by 12 weeks. There was a significant improvement in functional outcomes, with KSS scores improving from 42 ± 12 preoperatively to 86 ± 10 postoperatively (p< 0.001), while SF-36 physical component scores improved from 45 ± 8 to 75 ± 9 (p< 0.001). Complications included pin tract infections in 6 patients (14%), malunion in 2 (5%), and reoperations in 3 (7%), giving an overall complication rate of 21% of patients. Of note, there were no nonunions.

Conclusion: Ilizarov external fixation is effective in promoting bony union and improving functional outcomes in distal femoral fractures, with a manageable complication rate. This technique offers an excellent alternative to traditional surgical interventions, especially for complex cases, by enhancing recovery and minimizing complications.