Abstract
Aims and methods
We present a review of our use of the Ilizarov apparatus in a non-acute NGO hospital in Cambodia specialising in limb reconstruction. Frames are applied without on table image intensification. A retrospective case-note analysis of Ilizarov apparatus use for all indications was conducted. 53 frames were applied between November 2005 and October 2011. Indications for application were chronic open fracture, osteomyelitis, fracture malunion, infective and non-infective non-union, bone lengthening, primary bone tumour resection, ankle fusion, congenital deformity or pseudarthrosis, chronic hip dislocation, or a combination of the above.
Results
Median delay in presentation was 104 weeks for all indications (range 4–864). Median treatment length was 21 weeks (3–76). The most frequent complication was pin-site infection. This occurred in 18 patients (34%). Return to theatre occurred in 21 patients (40%). Indications were frame adjustment, pin addition or removal, addition of bone graft or re-osteotomy. Failure of union occurred in three patients. These rates are comparable with those published in both Asian and Western literature.
Conclusions
Our data demonstrate the versatility of the Ilizarov apparatus and its importance in limb reconstruction in a developing world setting. Our centre relies on it as a cost-effective tool for traditional and novel indications. In our centre the apparatus is applied without x-ray control and is maintained without a dedicated outreach pin-site care programme. Despite this our complication rates are comparable with western literature. We therefore recommend it as a safe and cost-effective tool for use in other developing world settings.
