title: The treatment of complex tibial shaft fractures by the Ilizarov method.
abstract: We report on the use of the Ilizarov method to   treat 40 consecutive fractures of the tibial shaft (35 AO 42C fractures and   five AO 42B3 fractures) in adults. There were 28 men and    12 women with a mean age of 43 years (19 to 81). The series included   19 open fractures (six Gustilo grade 3A and 13 grade 3B) and 21   closed injuries. The mean time from injury to application of definitive   Ilizarov frame was eight days (0 to 35) with 36 fractures successfully   uniting without the need for any bone-stimulating procedure. The   four remaining patients with nonunion healed with a second frame.   There were no amputations and no deep infections. None required   intervention for malunion. The total time to healing was calculated   from date of injury to removal of the frame, with a median of 166   days (mean 187, (87 to 370)). Minor complications included snapped   wires in two patients and minor pin-site infections treated with   oral antibiotics in nine patients (23%). Clinical scores were available   for 32 of the 40 patients at a median of 55 months (mean 62, (26   to 99)) post-injury, with 'good' Olerud and Molander ankle scores   (median 80, mean 75, (10 to 100)), 'excellent' Lysholm knee scores   (median 97, mean 88, (29 to 100)), a median Tegner activity score   of 4 (mean 4, (0 to 9)) (comparable to 'moderately heavy labour   / cycling and jogging') and Short Form-12 scores that exceeded the   mean of the population as a whole (median physical component score   55 (mean 51, (20 to 64)), median mental component score 57 (mean   53, (21 to 62)). In conclusion, the Ilizarov method is a safe and   reliable way of treating complex tibial shaft fractures with a high   rate of primary union.
authors.affiliation: The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, UK. patrickfoster@doctors.org.uk
authors.forename: P A L
authors.initials: PA
authors.lastname: Foster
authors.forename: S B
authors.initials: SB
authors.lastname: Barton
authors.forename: S C E
authors.initials: SC
authors.lastname: Jones
authors.forename: R J M
authors.initials: RJ
authors.lastname: Morrison
authors.forename: S
authors.initials: S
authors.lastname: Britten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017102:Fracture Healing; D005596:Fractures, Closed / Q000601:surgery*; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult