Clinical and functional outcomes of acute distal tibia fractures treated with Ilizarov external fixation: a retrospective study

Introduction Distal tibia pilon fractures are complex injuries involving the tibial articular surface. Managing these fractures requires balancing stable fixation with soft tissue preservation. The Ilizarov technique offers a minimally invasive alternative to traditional open reduction and internal fixation (ORIF), allowing for gradual correction and early weight bearing. This study aimed to evaluate functional and radiological outcomes in patients with distal tibia fractures managed by limited open reduction and Ilizarov fixation. Materials and Methods The study was conducted in a tertiary care hospital's Department of Orthopaedics over two years. The inclusion criteria were patients aged >18 years with distal tibia fractures. Exclusion criteria included refracture, previous surgeries, and associated vascular injury. The study included 20 patients (18 males, 2 females) with a mean age of 39.2 ± 10.5 years. Most injuries (80 %) were due to road traffic accidents. Fracture patterns were classified according to the AO-OTA classification. The surgical procedure involved placing the patient supine under spinal anesthesia. Traction was applied, and fluoroscopy was used to assess reduction. A three-ring tibial Ilizarov frame was assembled and applied, with additional fixation for the calcaneum. The median time to full weight bearing was 26 days. Results At frame removal, all cases had ankle stiffness, but two months post-removal, 85 % of cases had full ankle range of motion. The median time to frame removal was 17.5 weeks, and the median time to consolidation was 22 weeks. Patellar tendon bearing cast was applied for 3 weeks followed by a PTB brace with foot extension for the next 4 weeks. Discussion The Ilizarov technique should be considered as a viable option, especially for complex fracture patterns or cases with compromised soft tissue envelopes not amenable to ORIF. Conclusion The Ilizarov technique represents a valuable approach for managing distal tibia pilon fractures, demonstrating improved clinical outcomes and minimal complications.