Managing Difficult Fractures due to Ballistic Trauma with Ilizarov Ring Fixation

Abstract

20 fractures (7 femoral and 13 tibial) were treated with the illizarov apparatus between 2003 to 2006. All
were old injuries, previously managed by internal fixation (intramedullary rods), external fixation (Hoffman's
external fixators), or conservatively with traction and plaster of paris slabs. Ilizarov fixators were applied
to manage infected non-union with or without bone loss and malunion. Corticotomy and bone transport
was carried out in cases with significant bone loss. In others without any limb shortening and minimal
bony defect, bone grafting and compression was carried out. In one case valgus deformity along with
non-union was corrected. Early weight bearing with range of motion exercises for ankle and knee joints
were encouraged. Average fracture healing time was 12 months (8 to 18 months). All fractures healed with
<5° of malalignment. Complications included pin site inflammation/ infection, muscle transfixation, knee
and ankle joint stiffness and a wire fracture. The ilizarov device provided definitive fixation with acceptable
results in all cases.

Key words: Ilizarov ring fixator; distraction osteogenesis; bone transport; infective non-union;
corticotomy

DOI: 10.3126/mjsbh.v9i1.3482

Medical Journal of Shree Birendra Hospital Vol.9(1) 2010 1-8