Clinical and functional outcomes of acute distal tibia fractures treated with Ilizarov external fixation: a retrospective study
Introduction Distal tibia pilon fractures are complex injuries involving the tibial articular surface. Managing these fractures requires balancing stable fixation with soft tissue preservation. The Ilizarov technique offers a minimally invasive alternative to traditional open reduction and interna...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
2025-08-01
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| Series: | Гений oртопедии |
| Subjects: | |
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| Summary: | Introduction Distal tibia pilon fractures are complex injuries involving the tibial articular surface. Managing
these fractures requires balancing stable fixation with soft tissue preservation. The Ilizarov technique
offers a minimally invasive alternative to traditional open reduction and internal fixation (ORIF), allowing
for gradual correction and early weight bearing.
This study aimed to evaluate functional and radiological outcomes in patients with distal tibia fractures
managed by limited open reduction and Ilizarov fixation.
Materials and Methods The study was conducted in a tertiary care hospital's Department of Orthopaedics
over two years. The inclusion criteria were patients aged >18 years with distal tibia fractures. Exclusion
criteria included refracture, previous surgeries, and associated vascular injury. The study included 20 patients
(18 males, 2 females) with a mean age of 39.2 ± 10.5 years. Most injuries (80 %) were due to road traffic
accidents. Fracture patterns were classified according to the AO-OTA classification. The surgical procedure
involved placing the patient supine under spinal anesthesia. Traction was applied, and fluoroscopy was
used to assess reduction. A three-ring tibial Ilizarov frame was assembled and applied, with additional
fixation for the calcaneum. The median time to full weight bearing was 26 days.
Results At frame removal, all cases had ankle stiffness, but two months post-removal, 85 % of cases
had full ankle range of motion. The median time to frame removal was 17.5 weeks, and the median time
to consolidation was 22 weeks. Patellar tendon bearing cast was applied for 3 weeks followed by a PTB brace
with foot extension for the next 4 weeks.
Discussion The Ilizarov technique should be considered as a viable option, especially for complex fracture
patterns or cases with compromised soft tissue envelopes not amenable to ORIF.
Conclusion The Ilizarov technique represents a valuable approach for managing distal tibia pilon fractures,
demonstrating improved clinical outcomes and minimal complications. |
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| ISSN: | 1028-4427 2542-131X |