Abstract
Aim: To quantify the complication rate in Ilizarov surgery. This study establishes the complication rate for an experienced Limb Reconstruction Team composed of 3 surgeons, 2 specialist nurses and 2 physiotherapists involved with acute trauma, late trauma reconstruction and elective limb deformity cases.
Study Design: Retrospective analysis of prospectively collected data on complications.
Material: Complications in 304 patients, treated between January 1998 and April 2001 were reviewed. Complications relating to the pin site, bones, joints, neurovascular structures, pain, mental status of the patient and mechanical failure of the frame were documented.
Results: Of the 304 cases treated there were 103 complications (34%) in total. Twenty patients (6.6%) required re-admission for IV antibiotics or curettage of a ring sequestrum secondary to a pin site infection. Forty three patients (14%) experienced problems with non or delayed union, mal union, incomplete osteotomy, premature consolidation of the regenerate or fracture through a pin site. Twelve patients (4%( experienced neural problems in the form of nerve pain during distraction or permanent nerve damage. Twenty-one patients (6.9%) developed loss of joint motion sufficient to stop distraction or as a permanent sequelae of treatment. One patient (0.3%) suffered from depression during the period of treatment. Three patients (1%) required referral to the pain team. Mechanical failure of the frame was represented by three episodes (1%) of fine wire breakage despite re-useable hardware.
Analysis revealed no significant difference in complication rates between the calendar years. However, there was a significant difference between complication rates in frames applied for acute trauma, late presentation of trauma, and elective surgery. This difference did not appear to relate to time spent in the frame, and therefore seems to represent a separate variable. There was a disproportionate increase in complications in Ilizarov frames applied for upper limb problems.
Conclusion: This study provides a baseline for the commonly occurring problems associated with the practice of Ilizarov surgery in the United Kingdom and Ireland.
The abstracts were prepared by Mr Ray Moran. Correspondence should be addressed to him at Irish Orthopaedic Associaton, Secretariat, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11.
