Abstract
Background: The Ilizarov Method is well established for lower limb trauma and reconstruction. However, although the same principles apply, its use in the upper limb is less well described.
Aims of Study: To review indications and outcomes of all Ilizarov arm fixators applied by the two limb reconstruction surgeons in our unit.
Methods and Results: All patients treated using an upper limb Ilizarov frame were identified and reviewed. Demographic data, indications and durations of frames collected. Fifty-one cases identified. Average age 43 (17–81). Tertiary referrals in 63%. Previous surgery in 78%. Mechanism of injury included: 37% RTA, 40% simple falls. Reasons for frame usually multifactorial including 22 for non-unions. 43% of fixators applied acutely (< 6 weeks). Average frame time was 152 days (34–343). Over 80% achieved expected outcome –obtaining good function or fracture union. 14 needed further frame surgery including 5 for frame removal, 3 adjustments and 2 corticotomies. Most frames removed in clinic.
Complications: 30% superficial pin site infection. No deep wire infections. 1 wrist malunion requiring delayed correction. 2 patients had neurological complications from frame surgery. One radial palsy possibly from humeral plate removal. One median palsy due to pressure from wire. One patient had an above-elbow amputation for persistent infection.
Conclusions: The Ilizarov technique appears well tolerated and successful despite often infected or deformed tissues. Indication and intended purpose of arm frames very varied. This technique allows stabilization (with/without bone loss), treatment of non-unions and lengthening/bone transport. The Ilizarov Method is valuable for limb salvage/reconstruction.
Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland
