Our Experience in Treating Complex Open Tibial Shaft Fractures with Ilizarov External Fixation: A Retrospective Study of 23 Patients

Introduction:
ilizarov ring fixation has been used mainly in the treatment of complex open tibial fracture. Ilizarov ring fixation offers several advantages, such as simultaneous fracture union and distraction osteogenesis in addition to allowing early weight-bearing. The aim of this study was to find out the outcome ilizarov ring fixation of complex open tibial shaft fractures. Outcome measures included time to union, rates of union, nonunion, malunion, infection and implant failure.

Methods:
We retrospectively reviewed a consecutive series of 23 patients with open fracture of tibial shaft (two AO41A3, six AO43C and 15 AO42C) treated with an Ilizarov external
fixation at our level I trauma center, between 2014 and 2020.

Results:
Seventeen patients went on for complete fracture union within average time of 19.6 weeks. The mean age was 31.78 and ranged from 8 to 88. The mean Follow-up duration
was 10.5 months. Six patients developed nonunion and required further surgical intervention, eventually all of them went on complete union. Nine patients developed mild
malunions . There were no lower limb amputations, implant failures or deep infections.

Conclusions:
The Ilizarov ring fixation is considered a safe method in terms of avoiding osteomyelitis, compartment syndrome or amputations. It is also considered a reliable method as it
allows early mobilization and early fracture union with few and minimal malunion.