DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20183371

Analysis of results of nonunion tibial fractures Ilizarov external fixation

Pandillapalli Devanatha Reddy, Koramutla Harsha Kumar

Abstract


Background: Tibia is most exposed bone in the body and vulnerable to trauma and therefore its fractures are common among the long bone fractures. Tibia is the common site of non-union in long bone fractures. Management of non-union in long bone fractures is a challenging problem for orthopedic surgeons. When the defect is more than 4 cm then it needs bone transport.

Methods: Materials of this study comprised 20 cases of nonunions of tibia treated over 2½ years period from June 2006 to December 2009 in the Department of Orthopedics at Narayana Medical College, Nellore, Andhra Pradesh. This was a prospective study of nonunions of tibia treated by Ilizarov ring external fixators and incidental surgery.

Results: Out of 20 tibial non-unions, in 15 patients the fixator has been removed. In 4 patients the fracture had united but the fixators are in situ and they are in consolidation phase and the remaining 1 patient is in various stage of follow up. The results of the 15 patients in whom the fixators have been removed are studied. The hospitalization time from 15 days to 120 days. The average hospital duration is 44.04 days. The total time ranged from 4 months to 15 months. Average time is 9.25 months.

Conclusions: From this study we conclude that Ilizarov external fixator is a reliable, versatile and effective treatment for the treatment of tibia nonunion fractures.


Keywords


Tibia, Trauma, Fractures

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References


Anderson G. Bone graft for delayed union and union of the tibia. J Bone Joint Surg. 1996;48:591.

Albert M. Delayed union in fractures of the tibia and fibula. J Bone Joint Surg. 1944;26:566.

Bier Mann JS, Nepola JV. A unilateral bone transport system for segmental defects of bone. Ortho Trans 1991;15:639.

Campbell WC. Onlay bone graft for ununited fractures. Arches Surg. 1939;58:13.

Campbell WC. Transf Surgerence of the fibula as an adjunct to free bone graft in the tibial deficiency. J Orthop. 1919;1:625.

Candle RJ, stern PJ. Severe open fractures of the tibia. J Bone Joint Srg. 1987;69:801.

Segmuller G. Diagnostic use of 85 strontium in the preoperative evaluation of nonunion. Acta orthop Scand. 1970;41:150.

Weber BG, Cech O. Pseudoarthrosis. Bem Hans Huber. 1976.

Rosen H. Compression treatment of long bone pseudarthroses. Clin Orthop.1979;138:154.

Paley D. Current techniques in limb lengthening. J Pediatr Orthop. 1988;8:73.

Paley D. Problems, obstacles and complications of limb lengthening by Ilizarov technique. Clin Orthop. 1990;250:81-104.

Milch H. Tibiofibular synostosis for non-union of the tibia. Surgery. 1950;27:770.

Lamb RH. Posterolateral bone graft for nonunion of the tibia. Clin Orthop. 1969;64:114.

Kummer FJ. biomechanics of the Ilizarov external fixators. Bull Hosp J Dis Ortho Inst. 1989;49:140.

Kojimoto H, Yasui N, Goto T, Matsuda S, Shimomura Y. Bone lengthening in rabbits by callus distraction. J Bone Joint Surg. 1988;70:543-9.

Voronovich IP, Volchkevich PL. The treatment of bony defects in the tibia by the Ilizarov method. In experimental theoretical and clinical aspects of osteosynthesis developed at the KNIEKOT. 2nd International Conference Abstracts, Kurgan, USSR; 1986: 116.

Aaronvich AM, Shyachov VI, Payevski SS, Lepyech Rempel GD, Berezovskaya TP, et al. Rehabilitation by Ilizarov technique of patients with bony defects of tibia complicated by chronic osteomyelitis. In experimental theoretical and clinical aspects of transosseous ostesynthesis developed at the KNILEKOT. 2nd International Conference Abstracts, Kurgan, USSR; 1986: 74.