[Treatment of type II and III open tibial fractures with Ilizarov external fixation]

We evaluated the results of patients who were treated with Ilizarov external fixation for type II and III open tibial fractures.

Forty-five patients (4 females, 41 males; mean age 33 years; range 8 to 65 years) with open tibial fractures were treated with the Ilizarov external fixator. According to the Gustilo-Mendoza classification, the fractures were type II, IIIA, IIIB, and IIIC in 12, 20, 9, and 4 patients, respectively. The mean follow-up was 58 months and 4 days (range 42 months and 10 days to 66 months and 11 days). The fixators were applied for a mean of 17.2 weeks (range 6.8 to 55.7 weeks).

Union was achieved in all cases. A significant difference was observed between type II and III fractures in terms of time to union (p<0.05). Compared to type IIIA fractures, the time to union was significantly longer in type IIIB and IIIC fractures (p<0.05). The most frequent complication was pin-tract infections (27.1%). Refracture occurred in four cases (8.8%). Three patients developed late infections at the fracture site. Radiographically, the results were excellent in 14 patients (31%), good in 22 patients (48.8%), moderate in five patients (11.1%), and poor in four patients (8.8%). Functional results were excellent in 21 patients (46.6%), good in 20 patients (44.4%), and moderate in four patients (8.8%).

Despite technical difficulties and problems associated with pin-tract infections, the Ilizarov external fixator may be the preferred technique in open tibial fractures because of high union rates, the use of thin K-wires with minimal traumatic effect, and more successful functional results.