The application of llizarov technique in the treatment of comminuted distal tibia fractures

Abstract

Introduction. High-energy distal tibia fractures are characterized by great comminution and extensive lesions of the surrounding soft tissues. The risk of developing complications during treatment is high. The application of the Ilizarov's technique reduces the risk of complications significantly, and provides good final treatment results. Methods. In our prospective observational study 41 patients were included. Clinical characteristics were evaluated by Gustillo-Anderson, Checketts-Otterburns and AO/OTA classification. The ASAMI protocol was used to assess bone union. Functional treatment results were represented using the modified Karlström-Ollerud scoring system. Analysis and monitoring time (follow up) was 18 months. Results. Using radiographic and clinical parameters, we recorded complete healing in all fractures. In the group of 43B intra-articular fractures, circular fixator was removed after 16 weeks (range 13 -31), while in the 43C fracture type group, it was removed after 18 weeks (range 13 -29). The ASAMI evaluation of bone healing showed 31 (75%) excellent, 76 (15%) good, 3 (8%) satisfactory, and 1 (2%) poor result. Functional recovery results obtained after 6 months showed the mean value of 24.7 using the modified Karlström-Ollerud scoring system in three follow-up periods, which represents recovery. The results present 12 months after surgery showed the mean value of 27.6, representing satisfactory recovery, while during the last parameter measurement performed after 18 months, the value was 29.5, which indicates good functional recovery. Conclusion. Transosseous osteosynthesis Ilizarov treatment applied in closed and open comminuted distal tibia fractures showed good final bone and functional results with minimal complications, and contributed to better patient's quality of life.