Journal of Musculoskeletal Trauma

Arthroscopically Assisted Limited Open Reduction and Ilizarov External Fixation of Tibial Pilon Fractures: Jin Young Lee, Gab Lae Kim, Hyung Seok Oh, Kun Ho Shin, Deok Yong Park; J Korean Fract Soc 2006;19(2):176-181. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.176

Abstract: PURPOSE
To evaluate the clinical results of the pilon fractures treated with arthroscopically assisted limited open reduction and Ilizarov external fixation.
MATERIALS AND METHODS
This is a retrospective study of the clinical result, bone union, complication and postoperative ankle function of 22 pilon fractures treated with arthroscopically assisted limited open reduction and Ilizarov external fixation between January 1999 to March 2004.
RESULTS
Clinical follow up averaged 16 months, with an average age of 39.2. All patients with type 1 and 2 fracture had excellent or good score by Ovadia and Beals criteria. Closed fractures healed within 13 weeks and open fractures within 16 weeks after surgery in average. Average range of motion of the ankle was 12o dorsiflexion (0~20 degree) and 25o plantar flexion (15~35 degree).
CONCLUSION
Minimal soft tissue dissection and anatomical reduction are very important factor for minimizing complication and satisfactory ankle function. So, arthroscopically assisted limited open reduction and Ilizarov external fixation is an effective treatment option for tibial pilon fractures.

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Treatment of comminuted Tibial Fractures using Ilizarov Method: Eui Hwan Ahn, Sung Tae Lee, Hyeon Seok Kang; J Korean Soc Fract 1999;12(4):916-923. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.916

Abstract PDF: From March 1996 to March 1999, thirty two cases of comminuted tibial fractures were treated with Ilizarov external fixator. 13 cases were closed fractures and 19 cases open fractures. Among 19 open fractures, there were 3 cases of Gustilo type I, 10 cases of type II and 6 cases of type III fractures. All the cases could not be initially treated by open reduction and internal fixation because of open wound or severe comminution. Among 32 cases, 4 were tibial condyles, 22 were tibial shafts, 6 were tibial plafonds. All the cases were followed up from a minimum 12 months up to 35 months with an dverage of 22 months. We obtained satisfactory bony union in ail cases with the average duration of 18.1 weeks. Bone graft was done initially in two cases. Numerous complications were encountered, most commonly, joint stiffness and pin tract infection were developed but they were treated well. To avoid such complications, careful management was needed. According to Tuckers clafsification, the result was graded as excellent in 8, good in 18, fair in 4 and poor in 2 cases. We conclude that Ilizarov external fixatior is a very useful method for initial treatment in getting reduction, maintenance of reduction, early ambulation and fracture healing in cases of communited tibial fractures whether open or closed.

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Ilizarov External Fixation for Severe Open Tibial Shaft fractures in Adults: Jeung Tak Suh, Tae Wook Nam, Chong Il Yoo; J Korean Soc Fract 1999;12(3):549-556. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.549

Abstract PDF: PURPOSE
It is to evaluate and discuss the result of severe open tibial shaft fractures treated by Ilizarov external fixation.
MATERIALS and METHODS
From the January 1992 to July 1997, 34 cases of severe open tibial shaft fracture in adults were treated with Ilizarov external fixator. 20 males and 14 females were followed for at least 1 year.
RESULTS
Fractures were evenly distributed through proximal 1/3 to distal 1/3 and its pattern was mostly comminuted one. According to Gustilo-Anderson classification, it mainly consisted of type IIIa &IIIb(28 cases: 82%). Mean bony union time was 40.2 months. There were 5 cases(15%) of delayed union, 2 cases(6%) of nonunion, 5 cases(15%) of deep infection including 3 cases(9%) of osteomyelitis, 10 cases(29%) of pin tract infection, 4 cases(12%) of malunion and 11 cases(32%) of ankle stiffness.
CONCLUSION
Conclusively, in the first place, for the successful treatment with Ilizarov external fixator, determining appropriate indications is the most important. Secondly, active reconstruction of soft tissue environment and early prophylactic bone graft, if necessary, are also essential to shorten union time. Thirdly, meticulous care of pin site and ankle motion is needed for the prevention of the two most common complications even though they are considered to be minor.

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Treatment of Intraarticular Calcaneal Fractures using Ilizarov Exteranl Fixation: Byeong Yeon Seong, Dong Seong Park, Seung Jun Park, Sang Wook Kim; J Korean Soc Fract 1998;11(3):591-596. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.591

Abstract PDF

Open reduction and internal fixation (ORIF) is gaining in popularity as method of choice for the treatment of displaced intraarticular calcaneal fracture since diagnosis and classification of computed tomography have become routine. But early weight-bearing cannot be allowed by convertional ORIF, and delayed weight-bearing may contributed to heel had pain and dystrophy. We performed combined technique of limited internal fixation and Ilizrov external fixation to ten-cases of displaced intraarticular calcaneal fractures, between February 1994 and February 1996. The follow-up period in this study was at least two years. This method can provide not only anatomical reduction, but also stable fixation. None of patients complained of heel pad pain, which was attributed to the desensitization of the heel by early weight-bearing. None of patients went on to late collapse of the posterior facet. clinical results were rated as excellent in six, good in three, and fair in one case. Pin-track infection, complicated operative technique, cumbersomeness and expensiveness of the external fixator itself were shortcomings of this method. We consider this method as one of options for the treatment of displaced intraarticular calcaneal fracture.

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A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture
Jeong-Seok Moon, Woo-Chun Lee
Journal of the Korean Fracture Society.2009; 22(1): 13. CrossRef

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The Treatment of Infected Nonunion of Femur after Open Reduction and Internal Fixation: Hee Soo kyung, Joo Chul Ihn, Byung Chul Park, Yong Goo Kim; J Korean Soc Fract 1998;11(3):540-545. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.540

Abstract PDF: Infected nonunion developed after open reduction and internal fixation is one of the serious complications among the treatments of fracture of long bone. It is very difficult to eliminate the infection, to correct the deformity and defect at the same time obtaining union. All six cases were male, the average of age was 34 years old from 21 to 49. Five cases were closed fracture and one was open fracture. For the primary internal implant, five cases were plate and one was intramedullary nail. About the 6 cases of infected nonunion of femur from June, 1994 to October, 1996, we performed the following procedure : after removal of internal fixation, extensive debridememt, complete sequestrectomy, firm fixation with Ilizarov external fixator, compression at fracture site and early autogenous cancellous bone graft. We obtained following results : 1. The average duration of infection was 7.8 months, average duration of bone union was 5.8 months. Average duration of follow-up was 17.5 months. 2. The average shortening of leg was 1.4cm. 3. According to classification of Paley and Catagni, the bone results were excellent in all cases, functional results were excellent in 4 cases and fair in 2 cases. 4. In conclusion, firm fixation with Ilizarov fixator, sequestrectomy, early autogenous cancellous bone graft and compression is one of the good treatment modalities of infected nonunion of the femur.

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Treatment of Neglected Fracture-Dislocation of the Ankle Using llizarov Device: A case report: Hong Jun Han, Dong Churl Kim, Seong Ho Lee; J Korean Soc Fract 1995;8(3):615-619. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.615

Abstract PDF: There was a close correlation between the final clinical result and the quality of reduction of the fracture fragments. Fracture-dislocations of the ankle are relatively rare and unstable injuries in which anatomical reduction and difficult by closed method. More recently, anatomical reduction, secure internal fixation and early motion have been advocated as principle of treatment for a success ful clinical outcome in fracture-dislocation of the ankle. We reviewed the result of a case of the neglected ankle fracture-dislocation that have been reduced anatomically by closed method using a Ilizarov device. Clinical and radiographic results of the technique were satisfactory after length of follow-up thirty-eight months.

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