Evaluation of compound tibial fractures managed with an Ilizarov ring fixator

Praveen Ravi, Muthumanickam Ramanujam, Jambu Nageswaran, Sundar Suriyakumar


Background: The tibia is the most commonly fractured long bone and because of its location and the tenuous soft tissue coverage, its more prone for open fractures tibia than any other long bone. The ideal management of such fractures still remains controversial. We have evaluated the healing of fractures and functional outcomes in patients with open tibial fractures treated with an Ilizarov ring fixator.

Methods: 32 patients who had open fractures of the tibia (II, IIIA or IIIB) who were treated with an Ilizarov fixator were included in the study. The patients were followed up for a minimum period of 1 year after removal of the fixator. Functional and radiological results were analysed using association for the study of applications of methods of Ilizarov scoring.

Results: There were 20 cases of type IIIB, 7 cases of type IIIA, 5 cases of type II fractures. Union was achieved in all patients. Mean time for union was 25.2 weeks, with faster union times in type II, type IIIA fractures. Six cases of type IIIB needed flap cover. Limb discrepancy was seen in 3 cases. 17 cases of pin tract infections were seen, most of which were grade 3 and were managed with antibiotics. Two cases had delayed union, of which one was treated with bone marrow aspirate injection and the other one with bone grafting. At one year, 21 (65.6%) had excellent results, six (18.7%) had good results, four (12.5%) had fair outcomes and one (3.2%) had a poor result.

Conclusions: Despite the associated complications, Ilizarov fixator is the ideal treatment for compound tibial fractures.


Compound tibial fractures, Ilizarov fixators, Pin tract infections

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