An evaluation of Ilizarov technique in treating patients with open fractures of Tibia
Abstract
Introduction: Open fracture of the tibia is a very common incidence in the orthopedic treatment arena. Ilizarov method is a popular method of treating open fractures of the tibia after debridement and open reduction. It is comparatively a newer method in Bangladesh and has many advantages. We have very little research-oriented data regarding the effectiveness of this technique in treating open fractures of the tibia.
Aim of the study: The aim of this study was to evaluate the Ilizarov technique in the treatment of open fractures of the tibia.
Methods: This was a prospective observational study which was conducted in the Department of Orthopedics, Shaheed Ziaur Rahman Medical College, Bogura, Bangladesh during the period from January 2019 to December 2019. In total 27 patients with open tibial fractures were selected as the study population. Before starting the intervention, the written consents of the participant were taken and this study was approved by the ethical committee of the mentioned hospital. All data were processed, analyzed, and disseminated by MS Office and SPSS program as per need.
Results: According to the Karlstrom and Olerud criteria outcomes were assessed. Among total participants, the majority portion got 'excellent’ results which were 66.67%. Then 22.22%, 7.41%, and 3.70% participants got ‘Good’, ‘Fair’ and ‘Poor’ results respectively. As postoperative complications, local pain with motion and local edema was seen in 3 cases and painful tenting of skin in 5 cases. Delayed complications included pin tract infection in 6 patients, loss of 80 ankle dorsiflexion in 2 cases, shortening of 1 cm was seen in 1 case, 2 cases (5%) of united in 70 recurvatum as calculated radiologically, 2 cases of muscle wasting of the leg from 0.4 to 1.5 cm were found. No case developed the deep infection, non-union, or unacceptable malunion. Only one patient got 2 weeks more treatment than all the others patients.
Conclusion: In this current study, no case developed a deep infection, non-union, or unacceptable mal-union. The Ilizarov device is used worldwide for the treatment of several types of fractures. Low blood loss, prompt healing, and minimum complications may be considered as some good features of Illizarov technic for the treatment of open fracture of the tibia.
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References
Cannada LK, Anglen JO, Archdeacon MT, Herscovici D Jr, Ostrum RF. Avoiding complications in the care of fractures of the tibia. Instr Course Lect 2009; 58:27-36. [19385517]
Whittle AP, Wood ІІ GW. Fractures of the lower extremity. In: Canale ST. Campbell’s operative orthopedics. 10th ed. Philadelphia, 2003; p. 2754-2773.
Webb LX, Bosse MJ, Castillo RC, MacKenzie EJ; LEAP Study Group. Analysis of surgeon-controlled vari- ables in the treatment of limb threaten- ing type-ІІІ open tibial diaphyseal frac- tures. J Bone Joint Surg 2007;89: 923-28. [17473126] [http://dx.doi. org/10.2106/JBJS.F.00776]
Petrisor BA, Bhandari M, Schmitsch E. Tibia and fibula fractures. In: Bu- cholz RW, Court-Brown CM, Heck- man JD, Tornetta ІІІ P. Rockwood and Green’s fractures in adults. 7th ed. Philadelphia; Lippincott Williams & Wilikins 2010; p.1867-1923.
Wani N, Baba A, Kangoo K, Mir M. Role of early Ilizarov ring fixator in the definitive management of type ІІ, ІІІA and ІІІB open tibial shaft fractures. Int Orthop 2011; 35:915-23. [20445978] [http://dx.doi.org/10.100 7/s00264-010-1023-7]
Hasankhani E, Payvandi MT, Birjandinejad A. The Ilizarov ring external fixator in complex open fractures of the tibia. Eur J Trauma 2006; 32:63-8. [http://dx.doi.org/10. 1007/s00068-005-0031-6]
Papaioannou N, Mastrokalos D, Papagelopoulos PJ, Tyllianaksi M, Athanassopoulos J, Nikiforidis PA. Nonunion after primary treatment of the tibia fractures with external fixator. Eur J Orthop Surg Traumatol 2001; 11:231-35. [http://dx.doi.org/1 0.1007/BF01686895]
Gustilo RB. Management of open fractures, in Gustilo RB (Ed.). Orthopaedic Infection, diagnosis and treatment, 1st edition (Philadelphia:WB Saunders Company, 1989) 87-89.
Paul, H Kim; Seth, S Leopold (9 May 2012). "Gustilo-Anderson Classification". Clinical Orthopaedics and Related Research. 470 (11): 3270–3274. doi:10.1007/s11999-012-2376-6. PMC 3462875. PMID 22569719.
"Ovid: Externer Link". ovidsp.tx.ovid.com. Retrieved 2017-11-10.
Trafton PG. Tibial shaft fractures, in Browner BD, Jupiter JB, Levine AM, Krettek C (Eds.). Skeletal trauma: basic science, management and reconstruction, 4th edition, Vol. 2 (Philadelphia: Saunders, 1998) 2319-2451.
Karlstrom G, Olerud S. Fractures of the tibial shaft, a critical evaluation of treatment alternatives. Clin Orthop. 1974; 105: 82−115.
Tucker HL, Kendra JC, KInnebrew TE. Management of unstable open and closed tibial fractures using Ilizarov method, Clinical Orthopaedics and Related Research, 280, 1992, 125-135.
Shtarker H David R, Stolero J, Grimberg B, Soundry M. Treatment of open tibial fractures with primary suture and Ilizarov fixation, Clinical Orthopaedics an Related Research, 335, 1997, 268-274.
Keating JF, Obrier PF, Blachut PA, Meck RN, Broekhuse HM. Locking intramedullary nailing with and without reaming for open fracture of the tibial shaft, The Journal of Bone and Joint Surgery, 79 A, 1987, 334-341.
Hulth A. Basic science and pathology, current concept of fracture healing: Clinical Orthopaedics and Related Research, 249, 1989, 265-285.
