Abstract
Introduction: The use of Ilizarov frames is contraindicated in patients with psychiatric conditions, thought to be due to non compliance. We present our experience of treating five fractures with Ilizarov frame in four patients who sustained their injuries through parasuicide.
Method: Consecutive series of patients treated by a single surgeon at our institution. Five fractures in four patients, (one bilateral fracture) were treated with an Ilizarov fine wire frame. All fractures were comminuted distal tibia (pilon): one was B3.3, two C3.2 and a further two C3.3 using the AO system. Four out of five fractures were open Grade IIIA. Outcome was based on functional score (Olerud and Molander); SF 12 and radiological assessment.
Results: There were three females and the mean age was thirty-one years. Of the five fractures, three united successfully, at eight months; one achieved a malunion and one an aseptic non-union at 1 year
Discussion: Our experience suggests complex fractures can be treated favourably with circular frames in parasuicide patients. The patients were generally compliant with frame care and the outpatient monitoring was no different from any other patient with similar injuries.
Correspondence should be addressed to BLRS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
