scholarly journals A Prospective Observational Study on Efficacy of Ilizarov External Fixation in Infected Non-Union Tibial Fractures

2021 ◽  
Vol 8 (15) ◽  
pp. 932-938
Author(s):  
Avinash Gundavarapu ◽  
Vishal Singh ◽  
Prashant Kumar Mishra ◽  
Santhosh Kumar M
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Functional Results ◽  
High Energy ◽  
Tibial Fractures ◽  
Bony Union ◽  
Ilizarov External Fixator ◽  
Non Union ◽  
Ring Fixator ◽  
Study Results

BACKGROUND Open fractures and fractures caused by high-energy trauma are likely to get infected and result in non-union. Infected non-union of long bones is a problem in developing countries like India. Ilizarov external fixator was employed to correct all the complications associated with non-union such as bone gap, infection, shortening, and deformities. Stable fixation, corticotomy and bone transport was employed to reduce or eliminate infection at the same time achieving bone union and correction of limb length discrepancy. Our study assesses the efficacy and safety of Ilizarov external fixation in patients with infected non-union tibial fractures. METHODS A series of 30 patients with infected non-union of tibia were treated with Ilizarov external fixation in Yashoda super speciality hospital and regularly followed-up between May 2014 and April 2016 (2 years). Bony and functional results were estimated and correlated with existing studies. RESULTS Out of thirty patients treated, bony results were excellent in 17 patients, good in 8 patients, fair in 4 patients and poor in 1 patient. Functional results were excellent in 17 patients, good in 5 patients, fair in 5 patients, and poor in 3 patients. Average duration of the fixator period was 8.1 months (min - 3 months, max - 14 months). Average length of regenerate was 3.64 cm (min - 2 cm, max - 6 cm). Average lengthening index in the study was 2.09 months / cm. Our study in all 4 categories of Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria had approached Dror Paley’s Bony results and functional results. CONCLUSIONS In our study results have been encouraging in addressing all the complex problems by Ilizarov principle. Ilizarov external fixator system is the best device to treat infected non-union of tibia. Distal third of tibia is more prone for infection and non-union. Corticotomy or bone grafting is required for augmentation of the healing process. Almost all patients had varying degrees of oedema and pin track infections. Infection was controlled in all the cases and bony union was achieved, no patient had persistence of non-union and infection at the end of 2 years. KEYWORDS Ilizarov External Ring Fixator, Infected Non-Union, ASAMI Criteria, Bony Results, Functional Results, Bony Union

scholarly journals A retrospective study of ilizarov fixation in infected non-union tibia: 36 cases

2016 ◽  
Vol 2 (3) ◽  
pp. 70
Author(s):  
Rajesh Govindasamy ◽  
Ramkumar Gnanasundaram ◽  
Saravanan Kasirajan ◽  
Pajani Sengani ◽  
Jimmy J Meleppuram
Keyword(s):  
Functional Results ◽  
High Energy ◽  
Ilizarov Method ◽  
Non Union ◽  
Ring Fixator ◽  
Significant Challenge ◽  
Ilizarov Ring Fixator ◽  
Pin Tract Infection ◽  
Tract Infections ◽  
Ilizarov Fixation

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>Infected non-union of tibia is most frequently met due to high energy trauma and it poses significant challenge to the treating orthopaedic surgeon. The aim of the study is to evaluate the clinical and functional results in treating infected non-union of tibia by Ilizarov method.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> 36 patients with infected non-union of tibia with bone loss; shortening and deformity treated were retrospectively analyzed in the institution during the period of May 2010 to May 2015 were included in the study. The results were evaluated according to association for the study and application of the methods of Ilizarov (ASAMI) criteria. The Pin tract infections were assessed by Moore and Dahl Grading.<strong></strong></span></p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>The bony results were excellent in 65% patients, good in 20%, fair in 15%, and poor in nil. The functional results were excellent in 50% patients, good in 25%, fair in 15%, and poor in 10%. The most common recorded complication was pin tract infection.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>Ilizarov ring fixator still remains an excellent treatment modality for tibial non-union as it addresses to the problems associated with it.</p>

scholarly journals TIBIAL PLATEAU FRACTURES

2018 ◽  
Vol 25 (06) ◽  
pp. 810-814
Author(s):  
Saeed Ahmad ◽  
Tariq Mahmood ◽  
Muhammad Imran Haider
Keyword(s):  
External Fixator ◽  
Tibial Plateau ◽  
Case Series ◽  
High Energy ◽  
Tibial Plateau Fractures ◽  
Tibial Fractures ◽  
Female Ratio ◽  
Non Union ◽  
Hybrid External Fixator ◽  
Pin Track

Background: Tibial fractures is most common type of long bone fractures. Highspeed lifestyles with vehicles motorcycles as well as growing waves of violence, contributingincrease occurrence of tibial fractures. Tibial plateau fractures continues to be a challenge fororthopedic surgeon. Treatment of these fractures have been plagued by complications. Recentimprovements in the techniques and development of hybrid external fixator have revolutionizedthe treatment of such fractures. Objective: To evaluate the clinical outcomes of hybrid externalfixator in high energy Schatzkar V and VI tibial plateau fractures. Study Design: Descriptive,Case series. Period: 27 June 2013 to 26 June 2016. Setting: Nishtar Hospital, Multan. Materialand methods: A total of 125 patients with open and close tibial plateau fractures, 20 to 50 yearsof age of both genders were included in the study. Patients having history of pervious surgeryor intervention tibial plateau fractures, and h/o malignancy were excluded. All the patients wereoperated by a consultant orthopedic surgeon. Outcome was assessed at 16 weeks by serialradiological x-ray by formation of callus and noting any grade of pin track infection. Results; Ourstudy comprised of 125 patients having Schatzker V and Schatzker VI tibial plateau fractureswho met our inclusion criteria. Mean age of 38.925 ± 7.09 years. Majority of the patients 47(37.60%) were between 41 to 50 years of age. Mean duration since injury in our study was 13.18± 4.79 hours. Out of 125 patients, 102 (81.60%) were males and 23(18.40%) were females withmale to female ratio of 1.2:5.4. Fifty three (42.4%) patients presented with Schatzker V and 72(57.6%) had Schatzker VI type of tibial plateau fractures. In our study, non-union was seen in10cases (8.0%) and pin track infection was noted to be present in 19 (15.20%) patients. So, theacceptable outcome (achievement of union without non-union or pin track infection during 16weeks) was seen in 96(76.8%) patients. Conclusion: This study concluded that there is highrate of acceptable outcome (achievement of union without any non-union or pin track infectionduring 16 weeks) after hybrid external fixator of the open and closed fractures of tibial plateauamong the patients having schatzker-V and VI.

scholarly journals Distal humerus nonunions after failed internal fixation: Treatment with Ilizarov external fixator

2018 ◽  
Vol 146 (3-4) ◽  
pp. 169-173
Author(s):  
Slavko Tomic ◽  
Andreja Baljozovic
Keyword(s):  
Range Of Motion ◽  
External Fixation ◽  
External Fixator ◽  
Distal Humerus ◽  
Joint Space ◽  
Early Postoperative Period ◽  
Fixation Method ◽  
Bony Union ◽  
Dash Score ◽  
Ilizarov External Fixator

Introduction/Objective. Nonunions of distal humerus after unsuccessful surgical treatment represents challenging surgical problem. The complexity of this condition is increased by bone atrophy, scar tissue, poorly vascularized bone fragment, limited elbow mobility, osteomyelitis and local neurological damage. The advantages of using Ilizarov external fixation method are stable fixation, adequate fracture reduction and fragment compression accompanied by minimal soft tissue trauma, with the possibility of early elbow mobilization. This aim of this paper is to present the treatment results of 19 patients with nonunion of distal humerus after internal osteosynthesis managed by Ilizarov external fixation method. Methods. nineteen consecutive patients were treated with the Ilizarov external fixator. The study group includes 11 male and 8 female patients with an average age of 42 years. Surgical technique consisted of approaching the nonunion, removing loose fixation material, making resection and debridement of bone fragments, after which Ilizarov fixator was placed. Rehabilitation of the elbow started in early postoperative period. The functional status of the arm was evaluated using the DASH score (Disabilities of the Arm, Shoulder and Head). Results. All patients achieved solid bony union after average 7 months from application of external fixator. In 17 patients radiographic analysis indicated the preservation of joint space, while two showed degenerative changes. All patients showed improvement in elbow range of motion and significantly better DASH score with postoperative value of 21. Conclusion. As treatment of distal humerus nonunion, Ilizarov external fixation method provides successful healing and increased range of motion in the elbow.

scholarly journals Application of Intelligent Computer Information Assisted Taylor Three-dimensional External Fixation in the Treatment of Tibiofibular Fracture (Preprint)

2020 ◽  
Author(s):  
Hongfeng Sheng ◽  
Weixing Xu ◽  
Bin Xu ◽  
Hongpu Song ◽  
Di Lu ◽  
...  
Keyword(s):  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Tissue Injury ◽  
Plate Fixation ◽  
Soft Tissue Injury ◽  
Three Dimensional ◽  
High Energy ◽  
Tibial Fractures ◽  
Intelligent Computer

BACKGROUND Background: With the development of social economy, severe and complex tibial fractures caused by high-energy injuries such as traffic accidents have gradually increased. At present, the commonly used methods for the treatment of tibial fractures include plate fixation, intramedullary nail fixation, and external fixation. Most of these fractures are open wounds with severe soft tissue injury and wound contamination, and some even have bone defects, which makes the previous internal fixation treatment difficult. OBJECTIVE Objective: This study was aimed to explore Intelligent Computer Information Assisted Taylor Three-dimensional External Fixation for the treatment of tibiofibular fractures. METHODS Methods: 70 patients were collected and divided into Taylor three-dimensional external fixation (TSF) group (28 patients with severe tibial fractures treated with TSF) and the internal fixation group (42 patients with severe complicated tibiofibular fractures treated by internal fixation). After the treatment, the follow-up evaluation of Intelligent Computer Information Assisted Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures and concurrency the incidence of the disease, as well as the efficacy and occurrence of the internal fixation of the treatment of tibial fractures in our hospital. RESULTS Results: The results showed that Intelligent Computer Information Assisted Taylor's three-dimensional external fixator was superior to orthopaedics in the treatment of tibiofibular fractures in terms of efficacy and complications. CONCLUSIONS Conclusions: Intelligent Computer Information Assisted Taylor three-dimensional external fixation in the treatment of tibiofibular fractures is more effective, and the incidence of occurrence is low, is a new technology for the treatment of tibiofibular fractures which is worthy of clinical promotion. CLINICALTRIAL

Management of 30 infected nonunited tibial fractures by Ilizarov external fixator with acute shortening distraction technique with consideration of the causative organism

2017 ◽  
Vol 28 (4) ◽  
pp. 416-423
Author(s):  
Ahmed Samir Barakat ◽  
Ahmed Elguindy ◽  
Mohamed Elazab ◽  
Mohamed Hegazy ◽  
Kamal M.S. Abdel-Meguid ◽  
...  
Keyword(s):  
External Fixator ◽  
Tibial Fractures ◽  
Causative Organism ◽  
Ilizarov External Fixator ◽  
Acute Shortening

scholarly journals Open segmental fractures of the tibia treated by external fixation

2012 ◽  
Vol 140 (11-12) ◽  
pp. 732-737 ◽  
Author(s):  
Ivan Golubovic ◽  
Zoran Vukasinovic ◽  
Predrag Stojiljkovic ◽  
Zoran Golubovic ◽  
Sonja Stamenic ◽  
...  
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Tibial Fractures ◽  
Type I ◽  
Severe Injuries ◽  
Results Of Treatment ◽  
Additional Surgery ◽  
Segmental Fracture ◽  
Segmental Fractures ◽  
Angular Deformities

Introduction. Open segmental fractures of the tibia are rare but severe injuries. In these fractures the wide zone of injury (damage of all structures of the lower leg) creates very unsuitable biological conditions for healing of the fracture. Objective. The aim of our work was to present the results of treatment of patients with segmental open fractures of the tibia treated by external fixation. Methods. We analyzed treatment results of 21 patients with open segmental tibial fractures who were treated using the method of external fixation at the Clinical Center Nis from January 1, 1995 to July 31, 2010. The average age of the patients was 53 years; the youngest patient was 27 years and the oldest one 80 years. According to the Gustilo open fracture classification, there were 3 (14.3%) type I, 6 (28.6%) type II, 8 (38.1%) type IIIA, and 4 (19.0%) type IIIB. All the patients were treated by a unilateral type Mitkovic external fixator by Traffix Company. Results. Union was attained in 16 (76.2%) fractures without severe complications (pseudoarthrosis, chronic osteitis and angular deformities of over 10 degrees). Among severe complications associated with open segmental tibial fractures, in two cases we registered septic pseudoarthrosis, in one aseptic pseudoarthrosis and in two large angular deformities of the tibia after union, with a valgus of over 10 degrees and extremity shortening of over 2 cm which required additional surgery. Conclusion. External fixation by the use of Mitkovic external fixator is one of the methods of choice in the treatment of open segmental tibial fractures, which incorporated with antibiotic therapy provides good biomehanical conditions for segmental fracture healing that enables good stability of the segmental tibial fracture and decreases the risk of deep infections.

Comparison between External Locking Plate Fixation and Conventional External Fixation for Extraarticular Proximal Tibial Fractures: A Finite Element Analysis

2021 ◽  
Author(s):  
Dejan Blažević ◽  
Janoš Kodvanj ◽  
Petra Adamović ◽  
Dinko Vidović ◽  
Zlatko Trobonjača ◽  
...  
Keyword(s):  
Finite Element ◽  
External Fixation ◽  
External Fixator ◽  
Tibial Fracture ◽  
Locking Plate ◽  
Plate Fixation ◽  
Tibial Fractures ◽  
Proximal Tibial Fracture ◽  
Locking Plate Fixation ◽  
Maximum Stiffness

Abstract BackgroundGood clinical outcomes for locking plates as an external fixator to treat tibial fractures have been reported. However, external locking plate fixation is still generally rarely performed. This study aimed to compare the stability of external locking plate fixator with that of conventional external fixator for extraarticular proximal tibial fractures, using finite element analysis. MethodsThree models were constructed: (1) external locking plating of proximal tibial fracture with lateral proximal tibial locking plate and 5-mm screws (ELP), (2) conventional external fixation of proximal tibial fracture with an 11-mm rod and 5-mm Schanz screws (EF-11), and (3) conventional external fixation of proximal tibial fracture with a 7-mm rod and 5-mm Schanz screws (EF-7). The stress distribution, displacement at the fracture gap, and stiffness of the three finite element models at 30-, 40-, 50-, and 60-mm plate–rod offset from the lateral surface of the lateral condyle of the tibia were determined. ResultsThe conventional external fixator showed higher stiffness than did the external locking plate fixator. In all models, the stiffness decreased as the distance of the plate–rod from the bone surface increased. The maximum stiffness was 121.06 N/mm in the EF-11 model with 30-mm tibia–rod offset. In the EF-7 model group, the maximum stiffness was 40.00 N/mm in the model with 30-mm tibia–rod offset. In the ELP model group, the maximum stiffness was 35.79 N/mm in the model with 30-mm tibia–plate offsetConclusionsExternal locking plate fixation is more flexible than conventional external fixation, which can influence secondary bone healing. External locking plate fixation requires the placement of the plate as close as possible to the skin, which allow low-profile design, because the increased distance of the plate from bone can be too flexible for bone healing.

Management of segmental tibial fractures by an Ilizarov external fixator

2016 ◽  
Vol 29 (3) ◽  
pp. 680
Author(s):  
Ahmad Samy ◽  
Taher Abdelsatar ◽  
Mohammad Elsawy ◽  
Ahmad Zayda
Keyword(s):  
External Fixator ◽  
Tibial Fractures ◽  
Ilizarov External Fixator

scholarly journals Pilon Fracture: A Case Report of a 45-Year-Old Dental Technician

2014 ◽  
Vol 8 (1) ◽  
pp. 433-436 ◽  
Author(s):  
Pouya Mafi ◽  
James Stanley ◽  
Sandip Hindocha ◽  
Reza Mafi
Keyword(s):  
Lower Extremity ◽  
External Fixation ◽  
Motor Vehicle ◽  
High Energy ◽  
Tibial Fractures ◽  
Pilon Fracture ◽  
Distal Tibial Fractures ◽  
Vehicle Accidents ◽  
Dental Technician ◽  
Fall From Height

Pilon fractures are complex and difficult-to-treat fractures of the lower extremity that account for about 1% of all lower extremity fractures and up to 10% of tibial fractures. The injury is caused by high energy axial load either from motor vehicle accidents or a fall from height. The treatment of these fractures has caused controversy among surgeons due to mixed outcomes. Here we report a case of pilon fracture in a 45 year old male patient who has sustained the injury as a result of a fall from a height of approximately 12 feet. We describe why it is absolutely crucial that the patient is treated with external fixation initially and evaluate its merits and drawbacks as well as ways to minimize the complications associated with external fixation of open intra-articular distal tibial fractures.

Sign in / Sign up

Export Citation Format

Share Document