Affiliation:
1. Chirurgische Klinik und Poliklinik,
Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum,
Deutschland
2. Unfallchirurgie, Berufsgenossenschaftliches
Universitatsklinikum Bergmannsheil, Bochum, Deutschland
Abstract
Abstract
Introduction Open and closed fractures of the tibial shaft or distal tibia
can be challenging for surgeons to treat if the fractures are accompanied by
aggravating conditions, such as various accompanying diseases, pronounced soft
tissue injuries, osteomyelitis, and/or noncompliance. The aim of this
retrospective study was to present our approach and results with the Ilizarov
fixator as a treatment option for such individually complex cases. Materials
and Methods Between 2005 and 2018, 20 patients were treated with the
Ilizarov fixator for fractures of the tibial shaft/distal tibia. The indication
for this was a 2nd- to 3rd-degree open fracture in 10 patients, a 1st-degree
open fracture in one patient, and closed fractures in 9 patients. Aggravating
conditions included soft tissue injuries, osteomyelitis, leg deformities,
multiple traumas, smoking, alcohol/drug abuse, and obesity (BMI > 60). In
addition to demographic data, the time of fixator treatment, complications, and
the endpoint of consolidation were evaluated retrospectively. Results The
mean time of fixator treatment was 29 (range 15–65) weeks. Complete fracture
consolidation was achieved in 13 patients (65%) with the Ilizarov fixator. The
mean follow-up period after fixator removal was 36 (range 2–186) months in 14
patients. Five patients with complete consolidation were lost to further
follow-up. One patient was amputated. In six patients without union, internal
osteosynthesis was carried out. Conclusion The use of the Ilizarov
fixator is a treatment option for individual high-risk patients with
complicating courses but should be seen as a salvage procedure due to the high
complication rate and long treatment process.
Subject
Orthopedics and Sports Medicine,Surgery
Cited by
2 articles.
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