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Outpatient deformity correction: novel closed reduction technique transforms tibial trauma care
Gamal Hosny1, NourEldin Elmesalamy2, Salma Awadallah3
1Faculty of Medicine, Benha University, Banhā, Egypt.
Background:
In an era of healthcare cost containment, this study introduces a novel closed reduction technique using the Ilizarov circular external fixator for comminuted tibial fractures (AO/OTA 42C2-3), minimizing operative interventions and costs compared to internal fixation.
Methods:
We conducted a retrospective analysis of 20 consecutive patients with high-energy tibial fractures managed with a single Ilizarov frame. Postoperative deformities (angulation, translation, rotation) were corrected painlessly in outpatient settings without anaesthesia.
Results:
Eighteen patients (90%) achieved union with one frame application; median time to union (injury to frame removal) was 150 days. Two patients had delayed union resolving conservatively. All injuries resulted from road traffic collisions (42C2/42C3). No amputations or compartment syndromes occurred. Pin-tract infections in two patients (10%) required wire exchange. No malunions necessitated reoperation, though two patients (10%) suffered refractures requiring repeat Ilizarov treatment. Per modified ASAMI scores, most achieved excellent/good functional outcomes.
Conclusion:
This technique delivers reliable union with outpatient, anaesthesia-free deformity correction, avoiding internal fixation's risks (deep infection, compartment syndrome, malrotation) while optimizing cost-effectiveness. Multicenter validation is warranted.
