Assesment of Functional and Radiological Outcomes of Proximal Tibia Fractures Surgically Treated With Ilizarov...

Introduction and objectives Ilizarov ring fixators have long been used in the case of shaft fractures of long bones and infected non-union. The use of primary Ilizarov ring fixators in an intra-articular fracture has always been controversial and has its own set of requirements and challenges. We wanted to analyse the functional and radiological outcome of proximal tibia fractures and look for any complications that may develop during the postoperative follow-up period. Materials and methods This was a prospective observational study conducted on patients operated upon at a tertiary care centre in Odisha, India. This study included patients aged 16-70 years who had presented to the emergency or the outpatient department with displaced proximal tibia fractures of Shatzker type three to six. Exclusion criteria included patients with floating knee, pathological fractures of proximal tibia, undisplaced proximal tibia fractures, patients beyond the age limits, congenital deformities, unwilling patients, patients managed conservatively for other medical reasons, and patients with neurovascular deficits following the trauma. The functional scores used for the same were the Knee injury and Osteoarthritis Outcome Score (KOOS) and Association for the Study and Application of the Methods of Ilizarov (ASAMI) score and Rasmussen Radiological Score (RRS) was used for the radiological assessment of fracture site union. The participants were followed up at three weeks, six weeks, three months, six months, and 12 months. Results The patients had an average KOOS of 74.9 with the majority in the range of 75-100. The majority of the cases had an excellent ASAMI score. The RRS was found to be good in the majority of cases. All the patients were followed up for 12 months and an average of 7.4 months was observed for radiological union and Ilizarov frame removal. Conclusion Ilizarov ring fixator is an excellent device to aid in the union of the fractured fragments in case of proximal tibia fractures. This method aids in early weight bearing. It is a very versatile device and can also be used as a salvage procedure. However, the application of an Illizarov fixator has a slow learning curve. Excellent results can be achieved using an Ilizarov fixator by understanding its biomechanical properties and its principles.