Indian Journal of Orthopaedics Surgery

Innovative Education and Scientific Research Foundation

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Registered Under Government of India NGO – Indian Trust Act 1882

A comparative study of functional and radiological outcome in management of type iiib tibial fractures by ao and ilizarov external fixator

Article : Open access

Article type : Research Article

Volume : 6

Issue : 2

Year : 2020

Author : Ramesh Krishna K, Suresh Kumar G, Aradhana T R

Page no : 90-96

Abstract : Background a nd Objectives: Tibia fractures are relatively common & Annual incidence of open tibial fracture is 11.5 /1,00,000 persons. Majority of these fractures are open diaphyseal fractures, of which 60% are Gustillo type III. Open fractures of tibia are more commonly seen than any other long bones because of the subcutaneous location of the bone. External fixators offer several advantages in management of open tibial fractures. AO and Ilizarov are types of external fixators. Ilizarov technique is cost effective, primary and definitive treatment and offer acceptable stability for the fracture, minimal operative trauma and good access to soft tissues and offers high union rates. AO is simple and safe to apply can be used in management of open tibial fractures. This study was conducted to determine the comparison of Radiological & Functional outcome & complications of the acute Open tibial fractures treated with primary Ilizarov external fixator and AO external fixator. Materials and Methods: Randomized comparative Study period was from November 2017 to May 2019. Age group between 18– 60 years was considered. The follow up would be for one year. Initially for every 3 weeks in first 6 weeks for wound care, every 6weeks for one year and assessed by Radiological evidence of union of fracture and Functional assessment by Patient’s Functional and Bone results are assessed based on ASAMI and functional assessment done by knee and ankle joint Range of motion & complications. Results: This is a prospective study population consists of 40 patients with IIIB open Tibia fractures of mean age in AO group is 44.3 +/- 10.6 years with male preponderance. In AO group majority of fractures were 42B3 (40%) & 43A3 (35%). Ilizarov group majority are 43A3 (25%), 15% fractures of each 41A3, 42A1, 42A3 & 42C3. Mean Radiological union time was 22.84 +/- 2.3 weeks in AO group, 24.95 +/- 4.6 weeks in Ilizarov group & Non union rate is 1 (5%) case in both the group. ASAMI bone results & functional results was Excellent (25%), Good (70%) & Poor(5%) in AO group, whereas in Ilizarov group Excellent (65%),Good (30%) & Poor (5%). Ilizarov has good Functional scoring when compare to AO group. common complications encountered were Pin Tract Infections,pain,stiffness, limp. In AO group pin tract infections were seen in 50%(n-10) & In Ilizarov group pin tract infections were seen in 20%(n- 4). No case developed deep Infection, or Unacceptable malunion. Conclusion: Ilizarov external fixator being minimally invasive procedure interferes less with the blood supply. The construct is ring fixator, safe, stable (three dimensional stability) and enable the patient early Weight bearing after surgery and high union rates, even in highly comminuted fractures. Keywords: Type IIIB tibia fractures, Ilizarov external fixator, AO external fixator, ASAMI score