Definitive fixation of open tibial fractures using the Ilizarov ring fixator: an analysis of functional outcomes

Introduction Open tibial fractures are generally managed by wound debridement and temporary stabilisation with AO external fixators followed by delayed internal fixation provided the soft tissue cover is adequate and there is no infection. This study aims at analysing the factors influencing the outcome of treatment of open tibial fractures using external fixation with Ilizarov ring fixators as definitive method. Materials and methods Twenty eight patients of both sexes aged more than 18 years who presented with open tibial fractures were included as our study subjects. The open fractures were classified according to Gustilo‑Anderson classification of open fractures. Skeletal stabilisation was done either with Ilizarov ring fixators primarily or with AO external fixators in whom within 5 days since the injury the Ilizarov ring fixators were applied after thorough debridement of wounds. Patients were followed up first 4 weeks after the definitive procedure, then after 6 weeks, 3 months, 6 months and 1 year. The results were analysed using Tuckers criteria. Results We achieved union in 25 patients without infection. Three patients were lost for follow-up. In majority of patients (48 %) union occurred in 24 weeks. In 10 patients we had pin site infections. The functional outcome was studied using Tucker’s Criteria according to which 5 patients (20 %) had excellent outcomes, 9 patients (33 %) had good outcomes, 8 patients (29 %) had fair outcomes and 3 (16 %) had poor outcomes. Discussion Limitation of the present study is the absence of a comparison group, though it was possible because of the nature of the injuries that these patients had while arriving at the trauma care facility. Another limitation is the follow-up period. We followed the patients for one year but if we followed the patents for longer periods we could have assessed the long-term prognosis. Conclusion The definitive treatment of open tibial fractures especially Type 3B fractures with the Ilizarov Ring Fixator system is found be optimal and cost-effective.