Abstract
Introduction
Segmental tibia fractures are high-energy injuries that are difficult to treat. We report on the use of the Ilizarov Method to treat 40 consecutive AO42C (35) and AO42B3 (5) fractures by a single surgeon. Fractures with bone loss requiring transport were excluded, as were fractures initially treated with nail or plate.
Patients
28 adult males, 12 adult females, average age 43. The most common mechanism of injury was RTA (50%). 12 (30%) had associated injuries. 19 (48%) fractures were open (6 3A, 13 3B) and 21 closed. 24 (60%) had temporary monolateral external fixation before definitive treatment. The mean time from injury to definitive Ilizarov frame was 8 days.
Results
37 (93%) healed without the need for any bone-stimulating procedure. The 3 non-unions subsequently healed with a second frame. There were no amputations and no deep infections. All injuries healed within ten degrees of anatomical alignment radiologically. The total time to healing was calculated from date of injury to frame removal. Open fractures (mean 214 days, median 182) took longer to heal than closed fractures (mean 177 days, median 177). Minor complications included snapped wires (2) and minor pinsite infections treated with oral antibiotics (9).
Conclusion
The Ilizarov Method is a very safe technique to successfully treat segmental tibia fractures with high union rates (93%).
