Management and outcome of gap non-union of tibia by ilizarov ring fixator

Abstract

Road traffic accidents are of growing public health importance worldwide, contributing significantly to the global disease burden. Associated bone tissue defect and infection, commonly result in development of infected non-union. Non-union of long bones especially tibia when associated with infection has always been a challenge to orthopaedic surgeons. Bony union is not usually contained until the infection has been eradicated and there are usually coexisting problems of deformity. The objective of the study was, to evaluate Ilizarov fixator method in the treatment of gap non-union. A descriptive study was conducted on 25 patients admitted in Orthopaedic Department of Index Medical College, Hospital & Research centre, Indore from November 2022 to February 2024. Pre operative & post operative x-rays were done in each case. Debridement followed by fixator assembly and Uni-focal or bi-focal osteotomy followed by transport was done. Out of 25patients, 23 were male and 2 were female. The mean age of patients was 38years, with 60% being in 30-40years age group. The patients with grade II open fractures 11, grade IIIA were 6, grade I were 5 and patients with closed fracture were 3. Maximum of non-union were in the region of diaphysis and metaphysis. Our results showed that 76% of the patients has excellent or good results, of bone union. There were 48% excellent, 28% good, 16% fair and 08% poor functional results in our study. There were no failures in our study. Most common post-operative complications we came across is pin tract infection and equinus. Nearly all the complications were managed and outcome was good in these cases except for 2 cases wherein there were non-union, in which results were poor. Ilizarov ring fixator is an excellent treatment modality for gap non-union of tibia, in terms of union.