Evaluation of Complex Tibial Pilon Fractures Treated with Ilizarov External Fixator
BACKGROUND: Ilizarov external fixator is now considered a suitable alternate treatment modalityfor treatment of complex tibial pilon fractures with questionable soft tissue integrity; it allows early weight bearing without jeopardizing the fracture stability and bone healing. OBJECTIVE: The purpose...
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| Format: | Article |
| Language: | English |
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Liaquat University of Medical and Health Sciences
2018-06-01
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| Series: | JLUMHS |
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| Online Access: | https://www.lumhs.edu.pk/jlumhs/Vol17No02/pdfs/04.pdf |
| _version_ | 1797815716679778304 |
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| author | Mehtab Ahmed Pirwani Jagdesh Kumar Muhammad Soughat Katto Nusrat Rasheed Badaruddin Sahito Ghulam Mustafa Kaimkhani |
| author_facet | Mehtab Ahmed Pirwani Jagdesh Kumar Muhammad Soughat Katto Nusrat Rasheed Badaruddin Sahito Ghulam Mustafa Kaimkhani |
| author_sort | Mehtab Ahmed Pirwani |
| collection | DOAJ |
| description | BACKGROUND: Ilizarov external fixator is now considered a suitable alternate treatment modalityfor treatment of complex tibial pilon fractures with questionable soft tissue integrity; it allows early weight bearing without jeopardizing the fracture stability and bone healing.
OBJECTIVE: The purpose of study was to evaluate clinico-radiological outcome and morbidity of the Ilizarov external fixator used for fixation of complex tibial pilon fractures.
METHODS: This retrospective analytic cross-sectional study was conducted at Orthopaedic Surgery department, Dow Medical College / Dr Ruth Pfau Civil Hospital Karachi, from June 2014 to May 2017. A total of 17 consecutive patients with complex tibial pilon fracture (AO type 43C) operated with Ilizarov external fixator technique were evaluated functionally by using the American Orthopaedic Foot and Ankle Society scoring system (AOFAS) and radio-logically for fracture union (delayed, nonunion) after a mean followup of 6 months. Post-surgical complications were noted. Polytrauma patients with additional fracture in pelvis and spine, pathological fracture, delayed presentation (> 2 weeks) and AO type 43A & B were excluded from the study.
RESULTS: Total 17 patients (29.4% female and 70.6% male) with mean age 28 years (range, 17 - 48 years) were analyzed in this study. 11 (64.7%) fractures had left ankle while 6 (35.2%) fractures had right ankle involvement. The minimum follow-up was 3 months after complete frame removal. According to AO classification, C1 in 9 cases, C2 in 3 cases and C3 in 5 cases. All fractures were united in average 14.6 weeks (range 10-28 weeks). According to AOFAS scoring system, the final functional results were excellent in 5 (29.4%), good in 10 (58.8%) and fair in 2 (11.7%). There were 82.3% pin tract infections in this series. Ankle joint arthritis was noted in five patients. We had no instance of postoperative deep infection and neurovascular complications due to Ilizarov fixation.
CONCLUSIONS: The Ilizarov ring fixator is a minimal invasive procedure that offers biological advantages and is a suitable alternate for treatment of complex tibial pilon fractures with questionable soft tissue integrity providing fracture healing, rapid functional recovery, and avoidance of major complications associated with extensive operative dissection needed with plate osteosynthesis. |
| first_indexed | 2024-03-13T08:26:54Z |
| format | Article |
| id | doaj.art-88c1b5ff5b144799a5d0c3635f8ac5ff |
| institution | Directory Open Access Journal |
| issn | 1729-0341 2309-8627 |
| language | English |
| last_indexed | 2024-03-13T08:26:54Z |
| publishDate | 2018-06-01 |
| publisher | Liaquat University of Medical and Health Sciences |
| record_format | Article |
| series | JLUMHS |
| spelling | doaj.art-88c1b5ff5b144799a5d0c3635f8ac5ff2023-05-31T04:44:44ZengLiaquat University of Medical and Health SciencesJLUMHS1729-03412309-86272018-06-011702808510.22442/jlumhs.181720555Evaluation of Complex Tibial Pilon Fractures Treated with Ilizarov External FixatorMehtab Ahmed Pirwani 0Jagdesh Kumar1Muhammad Soughat Katto2Nusrat Rasheed3Badaruddin Sahito4Ghulam Mustafa Kaimkhani5Dow University of Health Sciences Karachi, Sindh-Pakistan.Dow University of Health Sciences Karachi, Sindh-Pakistan.Dow University of Health Sciences Karachi, Sindh-Pakistan.Dow University of Health Sciences Karachi, Sindh-Pakistan.Dow University of Health Sciences Karachi, Sindh-Pakistan.Dow University of Health Sciences Karachi, Sindh-Pakistan.BACKGROUND: Ilizarov external fixator is now considered a suitable alternate treatment modalityfor treatment of complex tibial pilon fractures with questionable soft tissue integrity; it allows early weight bearing without jeopardizing the fracture stability and bone healing. OBJECTIVE: The purpose of study was to evaluate clinico-radiological outcome and morbidity of the Ilizarov external fixator used for fixation of complex tibial pilon fractures. METHODS: This retrospective analytic cross-sectional study was conducted at Orthopaedic Surgery department, Dow Medical College / Dr Ruth Pfau Civil Hospital Karachi, from June 2014 to May 2017. A total of 17 consecutive patients with complex tibial pilon fracture (AO type 43C) operated with Ilizarov external fixator technique were evaluated functionally by using the American Orthopaedic Foot and Ankle Society scoring system (AOFAS) and radio-logically for fracture union (delayed, nonunion) after a mean followup of 6 months. Post-surgical complications were noted. Polytrauma patients with additional fracture in pelvis and spine, pathological fracture, delayed presentation (> 2 weeks) and AO type 43A & B were excluded from the study. RESULTS: Total 17 patients (29.4% female and 70.6% male) with mean age 28 years (range, 17 - 48 years) were analyzed in this study. 11 (64.7%) fractures had left ankle while 6 (35.2%) fractures had right ankle involvement. The minimum follow-up was 3 months after complete frame removal. According to AO classification, C1 in 9 cases, C2 in 3 cases and C3 in 5 cases. All fractures were united in average 14.6 weeks (range 10-28 weeks). According to AOFAS scoring system, the final functional results were excellent in 5 (29.4%), good in 10 (58.8%) and fair in 2 (11.7%). There were 82.3% pin tract infections in this series. Ankle joint arthritis was noted in five patients. We had no instance of postoperative deep infection and neurovascular complications due to Ilizarov fixation. CONCLUSIONS: The Ilizarov ring fixator is a minimal invasive procedure that offers biological advantages and is a suitable alternate for treatment of complex tibial pilon fractures with questionable soft tissue integrity providing fracture healing, rapid functional recovery, and avoidance of major complications associated with extensive operative dissection needed with plate osteosynthesis.https://www.lumhs.edu.pk/jlumhs/Vol17No02/pdfs/04.pdftibial pilon fracturesilizarovexternal fixatorminimal invasive |
| spellingShingle | Mehtab Ahmed Pirwani Jagdesh Kumar Muhammad Soughat Katto Nusrat Rasheed Badaruddin Sahito Ghulam Mustafa Kaimkhani Evaluation of Complex Tibial Pilon Fractures Treated with Ilizarov External Fixator JLUMHS tibial pilon fractures ilizarov external fixator minimal invasive |
| title | Evaluation of Complex Tibial Pilon Fractures Treated with Ilizarov External Fixator |
| title_full | Evaluation of Complex Tibial Pilon Fractures Treated with Ilizarov External Fixator |
| title_fullStr | Evaluation of Complex Tibial Pilon Fractures Treated with Ilizarov External Fixator |
| title_full_unstemmed | Evaluation of Complex Tibial Pilon Fractures Treated with Ilizarov External Fixator |
| title_short | Evaluation of Complex Tibial Pilon Fractures Treated with Ilizarov External Fixator |
| title_sort | evaluation of complex tibial pilon fractures treated with ilizarov external fixator |
| topic | tibial pilon fractures ilizarov external fixator minimal invasive |
| url | https://www.lumhs.edu.pk/jlumhs/Vol17No02/pdfs/04.pdf |
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