We intended to determine our rates of deep infection and non-union in severe open tibial fractures treated at our institution with Ilizarov frames. We retrospectively reviewed the case notes and radiographs of sixty consecutive cases of severe (Gustillo-Anderson Grade III) open fractures of the tibia treated in our tertiary referral unit with the ‘Flap and Frame’ technique. This technique involves early aggressive soft tissue and bone debridement and temporary skeletal stabilisation, followed by soft tissue coverage and then, when the soft tissues have settled, definitive skeletal stabilisation with the Ilizarov frame. The primary outcome measures were the presence of deep infection, occurence of union with the index frame, and any requirement for secondary amputation.Purpose of Study
Methods
We performed a retrospective study of treatment of 50 patients above the age of 65 years with Tibial metaphyseal and diaphyseal fractures. We studied the outcome by evaluation of all medical records and radiographs. The mean duration of follow-up was 11 months. The average hospital stay was 19 days and the mean time in frame was 112 days. There were 2 non unions,3 significant malunions,2 refractures and 1 patient underwent an amputation. Tibial fractures in the elderly are common and result in prolonged immobility and hospital admission. Fracture stabilization with an Ilizarov circular frame is an effective way of improving mobility with minimal additional morbidity, shorten hospitalisation time and achieve an excellent outcome.
