Evaluation of Complex Tibial Pilon Fractures Treated with Ilizarov External Fixator
Keywords:
Tibial pilon fractures, Ilizarov, External fixator, Minimal invasiveAbstract
BACKGROUND: Ilizarov external fixator is now considered a suitable alternate treatment modalityfor treatment of complex tibial pilon fractures with questionable soft tissue integrity; it allows early weight bearing without jeopardizing the fracture stability and bone healing.
OBJECTIVE: The purpose of study was to evaluate clinico-radiological outcome and morbidity of the Ilizarov external fixator used for fixation of complex tibial pilon fractures.
METHODS: This retrospective analytic cross-sectional study was conducted at Orthopaedic Surgery department, Dow Medical College / Dr Ruth Pfau Civil Hospital Karachi, from June 2014 to May 2017. A total of 17 consecutive patients with complex tibial pilon fracture (AO type 43C) operated with Ilizarov external fixator technique were evaluated functionally by using the American Orthopaedic Foot and Ankle Society scoring system (AOFAS) and radio-logically for fracture union (delayed, nonunion) after a mean followup of 6 months. Post-surgical complications were noted. Polytrauma patients with additional fracture in pelvis and spine, pathological fracture, delayed presentation (> 2 weeks) and AO type 43A & B were excluded from the study.
RESULTS: Total 17 patients (29.4% female and 70.6% male) with mean age 28 years (range, 17 - 48 years) were analyzed in this study. 11 (64.7%) fractures had left ankle while 6 (35.2%) fractures had right ankle involvement. The minimum follow-up was 3 months after complete frame removal. According to AO classification, C1 in 9 cases, C2 in 3 cases and C3 in 5 cases. All fractures were united in average 14.6 weeks (range 10-28 weeks). According to AOFAS scoring system, the final functional results were excellent in 5 (29.4%), good in 10 (58.8%) and fair in 2 (11.7%). There were 82.3% pin tract infections in this series. Ankle joint arthritis was noted in five patients. We had no instance of postoperative deep infection and neurovascular complications due to Ilizarov fixation.
CONCLUSIONS: The Ilizarov ring fixator is a minimal invasive procedure that offers biological advantages and is a suitable alternate for treatment of complex tibial pilon fractures with questionable soft tissue integrity providing fracture healing, rapid functional recovery, and avoidance of major complications associated with extensive operative dissection needed with plate osteosynthesis.
Downloads
Published
How to Cite
Issue
Section
License
Submission of a manuscript to the journal implies that all authors have read and agreed to the content of the undertaking form or the Terms and Conditions.
When an article is accepted for publication, the author(s) retain the copyright and are required to grant the publisher the right of first publication and other non-exclusive publishing rights to JLUMHS.
Articles published in the Journal of Liaquat University of Medical & health sciences are open access articles under a Creative Commons Attribution-Noncommercial - Share Alike 4.0 License. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal. This is in accordance with the BOAI definition of open access. In addition to that users are allowed to remix, tweak and build upon the work non-commercially as long as appropriate credit is given and the new creations are licensed under the identical terms. Or, in certain cases it can be stated that all articles and content there in are published under creative commons license unless stated otherwise.
