Publication: Treatment of grade IIIB opens tibial fracture by ilizarov hybrid external fixator
Date
2007
Authors
Article Type
Original Article
Journal Title
Journal ISSN
1812-2027
Volume Title
Pages
Pages: 177 - 180
Publisher
Kathmandu Unviversity
Abstract
Objective: We evaluated the results of patients who were treated with Ilizarov hybrid external fixator for type IIIB
open tibial fractures.
Materials and methods: 35 Gustilo grade IIIB tibial fractures of age between 18 to 42 years (22 male and 13
female) in which 12 distal fourth tibia (D/4) of C1.1 (6), C1.3 (6), 12 upper fourth Tibia (U/4) of A2 (8) and A3
(4) according to AO classification and 11 Tibial plateau fractures of Schatzker type VI (5) , V(5), IV(1) . All tibial
plateau, proximal fourth fractures and lower fourth fractures of tibia and fibula (Reversed Hybrid), treated with
Ilizarov hybrid fixator using two Ilizarov 5/8 rings and AO External fixator were followed up to 12-52 months.
Results: D/4 fractures were united at 31.1667±8.3046 wks, U/4 at 24.00±5.2915 and Tibial plateau at 15.545±4.160
weeks (p-0.00). ROM in tibial plateau type IV 130°±00, type V 124°±8.94° , type VI 125°±7.0711°, D/4 of type
C1.1 (50°±0.00), type C1.3 (43° ±5.7755) whereas full ROM in U/4 fractures. Pin tract infection occurred in 21% of
cases. Pain on walking in 20% of cases of type VI tibial plateau fractures and 80% of cases of type IV and V.
Problem free in rest of parameter of function of VI and 100% problem in IV and V. Pain at rest observed in 20% of
cases in type V. In 66.67% U/4 fractures had pain on walking but no other functions were compromised. In 33% D/4
fractures of C1.1 type had pain on walking only and had 1cm of shortening.
Conclusion: On the basis of our experience, we suggest adopting this method for functional limb salvage after
extensive complex high-energy injuries. This fixator is safe and versatile, effective in providing stability and
allowing early rehabilitation, although the indications for its use are very relatively specific.
Key words: Ilizarov hybrid external fixator, tibial plateau, upper fourth and distal fourth fractures, Clinical and
Functional outcome.
Description
Kumar P, Singh GK, Bajracharya S
Assistant Professor, Clinical epidemiologist, Senior Resident, Department of Orthopaedics, B. P. Koirala Institute of health sciences, Dharan, Nepal