Functional and Radiological Outcomes of Proximal Tibial Fracture with Compromised Skin Condition Treated with Ilizarov External Fixator
- 1. Associate Professor, Department of Orthopedics, Mayo Institute of Medical Science, Gadia, Barabanki, UP
- 2. Associate Professor, Department of Dermatology, Mayo Institute of Medical Science, Gadia, Barabanki, UP
- 3. Associate Professor, Department of Radiology, Mayo Institute of Medical Science, Gadia, Barabanki, UP
Description
Background: Proximal tibial fractures, complex and biomechanically challenging, become even more formidable with compromised skin conditions. Traditional interventions face limitations in addressing severe soft tissue injuries. Recent advancements highlight the Ilizarov external fixator as a promising alternative, offering dynamic solutions for fractures and soft tissue aspects simultaneously. Despite its established efficacy, there’s a gap in literature regarding its application in proximal tibial fractures with compromised skin conditions. This study aimed to assess Ilizarov’s use in such fractures and related outcomes. Methods: This prospective cohort study, conducted at a North Indian tertiary care center from July 2021 to June 2022, focused on patients with proximal tibial fractures treated with the Ilizarov external fixator. Ethical approval was obtained, and 56 eligible participants were consecutively enrolled. The intervention involved Ilizarov external fixator application within 24 hours of admission, tailored to fracture characteristics. Data collection included baseline demographics, intraoperative details, and follow-up assessments using Johner and Wruh’s criteria. Statistical analyses employed SPSS version 20.0, presenting results with descriptive statistics and considering a p-value < 0.05 as significant. Results: In our study, participants had a mean age of 41.72 years, with 73.2% males and 26.8% females. Co-morbidities included diabetes mellitus (8.9%) and hypertension (21.4%). Road traffic accidents were the primary mode of injury (69.7%), followed by assault (16.1%) and falls from height (14.2%). Fractures were predominantly on the right side (62.5%), closed (75.0%), with Tscherne’s Type 1, 2, and 3 fractures. Gustilo Anderson’s classification revealed open fractures: Grade I (35.8%), Grade II (21.4%), Grade III A (21.4%), and Grade III B (21.4%). Fixator duration varied, with 44.6% <15 weeks, 33.9% 15-17 weeks, 16.1% 18-20 weeks, and 5.4% >20 weeks. The mean duration of hospital stay was 12.56 days. Pin tract infections (17.9%), knee stiffness (12.5%), and limb shortening (8.9%) constituted postoperative complications. Conclusion: In conclusion, our study contributes to the growing body of knowledge surrounding Ilizarov external fixation for proximal tibial fractures with compromised skin conditions. While our outcomes are generally consistent with recent literature, the observed variations warrant continued exploration.
Abstract (English)
Background: Proximal tibial fractures, complex and biomechanically challenging, become even more formidable with compromised skin conditions. Traditional interventions face limitations in addressing severe soft tissue injuries. Recent advancements highlight the Ilizarov external fixator as a promising alternative, offering dynamic solutions for fractures and soft tissue aspects simultaneously. Despite its established efficacy, there’s a gap in literature regarding its application in proximal tibial fractures with compromised skin conditions. This study aimed to assess Ilizarov’s use in such fractures and related outcomes. Methods: This prospective cohort study, conducted at a North Indian tertiary care center from July 2021 to June 2022, focused on patients with proximal tibial fractures treated with the Ilizarov external fixator. Ethical approval was obtained, and 56 eligible participants were consecutively enrolled. The intervention involved Ilizarov external fixator application within 24 hours of admission, tailored to fracture characteristics. Data collection included baseline demographics, intraoperative details, and follow-up assessments using Johner and Wruh’s criteria. Statistical analyses employed SPSS version 20.0, presenting results with descriptive statistics and considering a p-value < 0.05 as significant. Results: In our study, participants had a mean age of 41.72 years, with 73.2% males and 26.8% females. Co-morbidities included diabetes mellitus (8.9%) and hypertension (21.4%). Road traffic accidents were the primary mode of injury (69.7%), followed by assault (16.1%) and falls from height (14.2%). Fractures were predominantly on the right side (62.5%), closed (75.0%), with Tscherne’s Type 1, 2, and 3 fractures. Gustilo Anderson’s classification revealed open fractures: Grade I (35.8%), Grade II (21.4%), Grade III A (21.4%), and Grade III B (21.4%). Fixator duration varied, with 44.6% <15 weeks, 33.9% 15-17 weeks, 16.1% 18-20 weeks, and 5.4% >20 weeks. The mean duration of hospital stay was 12.56 days. Pin tract infections (17.9%), knee stiffness (12.5%), and limb shortening (8.9%) constituted postoperative complications. Conclusion: In conclusion, our study contributes to the growing body of knowledge surrounding Ilizarov external fixation for proximal tibial fractures with compromised skin conditions. While our outcomes are generally consistent with recent literature, the observed variations warrant continued exploration.
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Additional details
Dates
- Accepted
-
2023-12-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue12,Article334.pdf
- Development Status
- Active
References
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