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Complications with Ilizarov ring fixator in open tibial fracture

Meet Kamal Singh Wadi, Sonia Garg, Lovjot Singh, Ramneet

Abstract: Introduction: The management of infected nonunion of the tibia is challenging, particularly with segmental bone loss, multiple draining sinuses, poor soft tissue cover, osteopenia, adjacent joint stiffness, limb deformity, or multidrug-resistant polymicrobial infection. The Ilizarov method permits early rehabilitation and addresses all the problems such as non-union, infection, shortening, soft tissue loss and deformity simultaneously at single stage. Ilizarov ring fixation technique has its own advantages as well as associated complications. Methods: The present study was a prospective randomized open study in which aim was to evaluate Complications with Ilizarov ring fixator in open tibial fracture. The study was conducted in 30 skeletally mature patients in Department of Orthopaedics, SGRD University of health sciences, Amritsar from July 2017 to May 2019. The patients were assessed clinically based on history and physical examination. Radiological evaluation using plain antero-posterior and true lateral radiographs of the involved leg was done and evaluated by complications.Results: Mean age was 37.7 years. Out of 30 cases 24(80%) were male and 6(20%) were female. Right tibia was involved in 24 cases out of 30 cases. 29 cases had history of road side accident and 1 had history of fall from height. In present study following complications were noted, limp in 12 cases(40%), ankle stiffness in 7 cases(23.33%), pin site infection in 9 cases(30%), limb oedema in 7 cases(23.33%), knee stiffness in 3 cases(10%), loosening of pins in 2 cases(6.67%), deformity in 2 cases(6.67%) and refracture in 1 case(3.33%). There was no complication of neurovascular injury, malunion, breakage of wires, axial deviation or limb length discrepancyConclusion: Limp and Pin tract infection were the most common complications. Most complications can be prevented by diligent post-operative care. Complications if diagnosed early can be managed effectively. As such advantages of Ilizarov ring fixator outweigh the associated complications.
Keywords: stiffness / limb / pin / history / ring / fixator in open / open tibial fracture

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