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Wheeless' Textbook of Orthopaedics

Wheeless' Textbook of Orthopaedics

C.R. Wheeless MD

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Wheeless' Textbook of Orthopaedics


Tibial fractures. The Ilizarov alternative.

Schwartsman-V. Martin-S-N. Ronquist-R-A. Schwartsman-R.

Department of Orthopaedic Surgery, Hurley Medical Center, McLaren

Clin-Orthop [m. 1992 [1mMay [m. (278). P 207-16.

Between February 1988 and [1mMay [m 1989, 17 consecutive patients

with 18 tibial fractures were treated using the Ilizarov method

and apparatus. Injuries included four closed fractures and 14

open fractures. There were three Grade I open, four Grade II open,

and seven Grade III open tibial fractures. Indications for

application of the Ilizarov frame included fractures that were

determined to need surgical management primarily, or fractures

that had failed to heal by other treatment methods, either

operative or nonoperative. Patients averaged 17.7 months of

follow-up treatment. One patient was lost to follow-up treatment

after the fracture healed and the device was removed. To date, all

fractures are healed. There was one delayed union, which

subsequently healed with a second application of the device.

Complications included two late wound infections, both in Grade

III open fractures. These occurred after removal of the Ilizarov

apparatus. The average time from application of the device to

complete fracture healing was 5.6 months, with a range of 3.25 to

13 months. This compares favorably with the results described for

other treatment modalities. These results indicate that the

Ilizarov method is indeed a useful adjunct in the orthopedic

armamentarium for the treatment of either open or closed tibial

fractures. No practical contraindications to the use of the

Ilizarov device in the management of tibial fractures were

encountered. Author-abstract.



Tibial fractures. The Ilizarov alternative.

Schwartsman-V. Martin-S-N. Ronquist-R-A. Schwartsman-R.

Department of Orthopaedic Surgery, Hurley Medical Center, McLaren

Clin-Orthop [m. 1992 [1mMay [m. (278). P 207-16.

Between February 1988 and [1mMay [m 1989, 17 consecutive patients

with 18 tibial fractures were treated using the Ilizarov method

and apparatus. Injuries included four closed fractures and 14

open fractures. There were three Grade I open, four Grade II open,

and seven Grade III open tibial fractures. Indications for

application of the Ilizarov frame included fractures that were

determined to need surgical management primarily, or fractures

that had failed to heal by other treatment methods, either

operative or nonoperative. Patients averaged 17.7 months of

follow-up treatment. One patient was lost to follow-up treatment

after the fracture healed and the device was removed. To date, all

fractures are healed. There was one delayed union, which

subsequently healed with a second application of the device.

Complications included two late wound infections, both in Grade

III open fractures. These occurred after removal of the Ilizarov

apparatus. The average time from application of the device to

complete fracture healing was 5.6 months, with a range of 3.25 to

13 months. This compares favorably with the results described for

other treatment modalities. These results indicate that the

Ilizarov method is indeed a useful adjunct in the orthopedic

armamentarium for the treatment of either open or closed tibial

fractures. No practical contraindications to the use of the

Ilizarov device in the management of tibial fractures were

encountered. Author-abstract.

 
 
 
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