title: Treatment of distal tibial fractures with the Ilizarov external fixator--a prospective observational study in 39 consecutive patients.
abstract: BACKGROUND
  The management of displaced distal tibial fractures is still controversial. The different internal fixation techniques are often burdened by relatively high complication rates. Minimally invasive techniques with ring fixators have been introduced as an alternative allowing immediate reduction and stabilization, avoiding a staged protocol. The aim of this prospective study was to analyze the clinical and radiographic outcome the Ilizarov technique in patients with distal metaphyseal tibial fractures, with or without intra-articular involvement.
  
  
  METHODS
  Thirty-nine consecutive patients with isolated fractures treated with the Ilizarov technique were followed prospectively for one year. Depending on the type of fracture, 4 or 5 rings were used, in some cases with additional foot extension. Unrestricted weight-bearing was allowed in all cases. Pre- and post-operatively conventional radiographs, post-operative pain assessment and complications were evaluated. The function was evaluated clinically and with self-appraisal protocols: EQ-5D, NHP and FAOS.
  
  
  RESULTS
  No patient developed compartment syndrome or deep venous thrombosis. Pin infections were frequent, but they were mostly superficial and were treated with antibiotics and/or the removal of isolated pins. Two patients required debridement. One of them had a deep infection and developed a residual deformity which was corrected and healed after re-operation. Another patient had a severe residual deformity. The fixator was removed after a median period of 16 weeks (range 11-30). The radiological results were poor in 5 patients but the overall self-appraisal showed satisfactory results in 36 patients.
  
  
  CONCLUSIONS
  The Ilizarov method allowed early definitive treatment with a low complication rate and a good clinical outcome.
authors: Department of Orthopaedics, Central Hospital (Kärnsjukhuset), SE-541 85, Skövde, Sweden. telmo.ramos@vgregion.se
authors: Telmo
authors: T
authors: Ramos
authors: Jón
authors: J
authors: Karlsson
authors: Bengt I
authors: BI
authors: Eriksson
authors: Lars
authors: L
authors: Nistor
mesh_terms: D000328:Adult; D000368:Aged; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018889:Ilizarov Technique / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D013978:Tibial Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult