Abstract
Background
The circular Ilizarov frame is a well-established method of external fixation used in the acute treatment of fractures. In our unit, based on our experience, we have changed practice from an all-wire construct to a hybrid, incorporating one 5mm titanium half-pin in the distal reference construct. We were able to compare the all-wire construct against this hybrid in terms of time to union and complications.
Methods
All patients who underwent circular frame fixation between 2009 and 2016 for Schatzker IV-VI tibial plateau fractures at one district general hospital were included in the study. The date of union was noted and time to union was calculated.
Results
A total of 151 patients were identified for the study. Of these, 17 were excluded due to loss to follow up. In total, 134 patients were included, 74 in the all-wire group and 60 in the hybrid group. Mean time to union was 155.5 days and 114.3 days respectively (p<0.01). Time spent in frame was therefore shorter in the hybrid group. There was no incidence of deep infection in either group and rates of superficial infection were comparable amongst both groups. Previously published data shows there is no difference between the groups in functional scores and SF scores.
Conclusions
These results suggest that the hybrid method of Ilizarov fixation is superior to the classical all-wire method. Use of the hybrid construct will reduce time to union, thus improve patient tolerance and reduce associated complications.
