Treatment of the Segmental Fractures of Tibia with Ilizarov External Fixation

Purpose: To emphasis an effectiveness of the Ilizarov circular external fixator in treatment of the complicated segmental fractures of the tibia. Materials and Methods: We had analyzed 15 cases in 14 persons, treated from November 1993 to March 2000. We analyzed several considering factors including age, etiology, type of fracture, number of the segmentation, associated injuries, open or closed fracture, healing time, additional bone graft, clinical results and complications. Results: The mean period of follow up was 22 months. The mean age was 45 years. The etiology was traffic accident in 13 persons. Open fracture were 11 cases (73%). Associated injuries were noted in 8 persons (53%). The number of segmentation were three segments in 9 cases (60%) and four segments in 6 cases (40%). Additional manipulations after first application were needed in 10 cases (67%). Bone graft were performed in 5 fracture site (9.8%), proximal fracture site in two and distal in two, middle in one. Mean period of application of external fixator for healing was 8.1 Months. Procedures for soft tissue injuries performed in 3 cases including two split thickness skin graft and distant flap surgery. The results were graded as excellent in 5 cases, good in 2 cases, fair in 1 cases, poor in 7 cases. Limitation of motion in ankle joint was major cause of poor results. Conclusion: We considered that ilizarov circular external fixator is one of effective treatment modality in treatment of the complicated segmental tibia fractures.

[1]  P. Broos,et al.  The difficult healing of segmental fractures of the tibial shaft , 2004, Archives of Orthopaedic and Trauma Surgery.

[2]  R. Galpin,et al.  Morbidity resulting from the treatment of tibial nonunion with the Ilizarov frame. , 2002, Canadian journal of surgery. Journal canadien de chirurgie.

[3]  E. Schemitsch,et al.  Effect of Unreamed, Limited Reamed, and Standard Reamed Intramedullary Nailing on Cortical Bone Porosity and New Bone Formation , 2001, Journal of orthopaedic trauma.

[4]  R. Sanders,et al.  Percutaneous plating in the lower extremity. , 2000, The Journal of the American Academy of Orthopaedic Surgeons.

[5]  K. S. Christensen,et al.  Ilizarov treatment of tibial nonunions results in 16 cases. , 2000, Acta orthopaedica Belgica.

[6]  A. Kumar,et al.  Treatment of complex (Schatzker Type VI) fractures of the tibial plateau with circular wire external fixation: retrospective case review. , 2000, Journal of orthopaedic trauma.

[7]  L. Claes,et al.  Fixation technique influences osteogenesis of comminuted fractures. , 1999, Clinical orthopaedics and related research.

[8]  J. Suh,et al.  Ilizarov External Fixation for Severe Open Tibial Shaft fractures in Adults , 1999 .

[9]  S. Ariyan,et al.  Salvage of open tibial fracture with segmental loss of tibial nerve: case report and review of the literature. , 1999, Journal of orthopaedic trauma.

[10]  E H Schemitsch,et al.  Influence of plate design on cortical bone perfusion and fracture healing in canine segmental tibial fractures. , 1999, Journal of orthopaedic trauma.

[11]  D. Ring,et al.  Infected nonunion of the tibia. , 1995, Clinical orthopaedics and related research.

[12]  K. Koo,et al.  Tibial bone defects treated by internal bone transport using the Ilizarov method , 1998, International Orthopaedics.

[13]  Sung Jin Park,et al.  Treatment of Open Fractures of the Tibial Shaft by Sequential Compression technique in Ilizarov device , 1998 .

[14]  M. Kim,et al.  Treatment of Tibial Fractures with the Ilizarov External Fixator , 1998 .

[15]  A. Lerner,et al.  Ilizarov external fixation in the management of bilateral, highly complex blast injuries of lower extremities: a report of two cases. , 1998, Journal of Orthopaedics and Trauma.

[16]  E H Schemitsch,et al.  Effect of limited and standard reaming on cortical bone blood flow and early strength of union following segmental fracture. , 1998, Journal of orthopaedic trauma.

[17]  Kwang-Won Lee,et al.  Treatment of Unstable Open Tibial Fractures with Ilizarov System , 1998 .

[18]  E. Schemitsch,et al.  Cortical bone blood flow in loose and tight fitting locked unreamed intramedullary nailing: a canine segmental tibia fracture model. , 1998, Journal of orthopaedic trauma.

[19]  K. Song,et al.  Treatment of Tibial Fractures using the Ilizarov External Fixator , 1998 .

[20]  Young Chang Kim,et al.  Treatment of Open Type-III Tibial Shaft Fractures -Comparison Between Ilizarov External Fixation and Secondary Intramedullary Nailing- , 1998 .

[21]  G. Hosny,et al.  The treatment of infected non-union of the tibia by compression-distraction techniques using the Ilizarov external fixator , 1998, International Orthopaedics.

[22]  M. Soudry,et al.  Treatment of Open Tibial Fractures With Primary Suture and Ilizarov Fixation , 1997, Clinical orthopaedics and related research.

[23]  G. Dendrinos,et al.  Use of the Ilizarov technique for treatment of non-union of the tibia associated with infection. , 1995, The Journal of bone and joint surgery. American volume.

[24]  M. Swiontkowski,et al.  Cortical Bone Blood Flow in Reamed and Unreamed Locked Intramedullary Nailing: A Fractured Tibia Model in Sheep , 1994, Journal of orthopaedic trauma.

[25]  C. Shih,et al.  Segmental Tibial Shaft Fractures Treated with Interlocking Nailing , 1993, Journal of orthopaedic trauma.

[26]  L. Naggar,et al.  Treatment of large bone defects with the Ilizarov technique. , 1993, The Journal of trauma.

[27]  E. E. Johnson,et al.  The treatment of infected nonunions and segmental defects of the tibia by the methods of Ilizarov. , 1992, Clinical orthopaedics and related research.

[28]  H L Tucker,et al.  Management of unstable open and closed tibial fractures using the Ilizarov method. , 1992, Clinical orthopaedics and related research.

[29]  David M. Wall,et al.  Management of segmental defects by the Ilizarov intercalary bone transport method. , 1992, Clinical orthopaedics and related research.

[30]  P. Kelly,et al.  Effect of fracture fixation on cortical bone blood flow , 1990, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[31]  N. Milicevic Deficit (14 cm) of the tibia solved by a double sliding graft using the Ilizarov apparatus. , 1990, Journal of orthopaedic trauma.

[32]  M. Swiontkowski,et al.  Treatment of open fractures of the tibial shaft: Ender nailing versus external fixation. A randomized, prospective comparison. , 1989, The Journal of bone and joint surgery. American volume.

[33]  Pearson Rl,et al.  The Ilizarov technique in the treatment of infected tibial nonunions. , 1989 .

[34]  C. Perry,et al.  The Ilizarov technique in the treatment of infected tibial nonunions. , 1989, Orthopaedic review.

[35]  K. M. Chan,et al.  The management of type III open tibial fractures. , 1984, Injury.

[36]  F. Sotgiu,et al.  Intramedullary nailing in segmental tibial fractures. , 1981, The Journal of bone and joint surgery. American volume.

[37]  O. Langård,et al.  Segmental tibial shaft fractures. , 1976, Acta orthopaedica Scandinavica.