A novel technique of managing compound tibia fractures with severe bone defects using the Ilizarov technique: A case series

Introduction: One of the commonly encountered surgical dilemmas for most orthopaedic trauma surgeons is the management of compound tibia fractures with significant bone defects. We used the Ilizarov technique to solve this complex problem using an ilizarov fixator over an intramedullary tibia nail. We present a case series of five such patients with compound tibia fractures with significant bone loss managed by bone transport over nail using Ilizarov technique. Materials and Methods: This was a prospective study conducted between November 2013 and September 2016. A total of five patients with open type 3B fracture of tibia classified as per GustiloAnderson classification with bone loss of more than 5 cm following a road traffic accident who presented to us in the emergency department of JSS Hospital, Mysore were included in this study Results: The mean duration of application of the external fixator was 9.2 months. All fractures united in 13.2 months, ranging 9-17 months. The mean external fixator index was 1.4months/cm. The mean follow up period was 9 months, ranging 7 to 24 months. The most common complication encountered was pin tract infection. One patient in our series had knee joint stiffness. The functional and radiological outcome was graded by the operating surgeon as excellent in two patients and good in three patients as per Paley criteria. Conclusion: Our technique combining distraction osteogenesis and bone transport over nail using Ilizarov technique successfully treated tibial fractures with bone loss in a small group of patients. This technique had favourable bone union time, external fixator time, EFI, and clinical results compared with reported parameters in studies of other approaches mentioned.