Common Complications of Ilizarov External Fixator

Authors

  • Abid Ali Department of Orthopaedics, Khyber Teaching Hospital, Peshawar Author
  • Hidayat ullah Department of Orthopaedics, Khyber Teaching Hospital, Peshawar Author
  • Muhammad Shoaib Khan Department of Orthopaedics, Khyber Teaching Hospital, Peshawar Author
  • Imran Ali Department of Orthopaedics, Khyber Teaching Hospital, Peshawar Author
  • Ahmad Jawad Mufti Department of Orthopaedics, Khyber Teaching Hospital, Peshawar Author
  • Qaisar Azem Department of Orthopaedics, Khyber Teaching Hospital, Peshawar Author
  • Asghar Essa Department of Orthopaedics, Khyber Teaching Hospital, Peshawar Author

Keywords:

Ilizarov frame. Complication

Abstract

Objectives: To evaluate the complications of Ilizarov external fixator.

Methods: This descriptive study was conducted between January 2012 and December 2016. Data includes demographics, functional outcome and complications of surgery were documented on a pre-formed proforma. Ninety patients requiring Ilizarov fixator fixation for various indications were studied. A; the record was kept in database.

Results: 90 patients were treated with Ilizarov for different indications. Male population was dominant, 65(72.2%)) while only 25(27.8%) were females. The fixator was applied for an average of 17.9 ±10.3 SD weeks with a range of 7-48 weeks. Outcome graded as per ASAMI criteria as excellent in 60 (66.6%), good in 21 (23.33%), fair in 6 (6.66%) and poor in 3 (3.33%) patients. The main complications in 29 (32.2%) cases were infection, of which 4 (4.44%) were major infections and 25 (27.7%) were minor pin tract infections. Joint stiffness was found in 12 (13.3%) patients and limb shortening in 5 (5.5%) patients of more than 2.5 cm.

Conclusion: Observing Ilizarov principles can reduce complications. Cleaning of pin tracts should be done to minimize infection and vigorous range of motion exercises and weight bearing to reduce joint stiffness. Respecting planes would reduce neurovascular injuries.

Despite its complications, this is still a valuable tool for treating complex skeletal disorders which otherwise would require amputations.

References

1. Paley D. Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res. 1990 Jan;(250):81–104.
2. Antoci V, Ono CM, Antoci V Jr, Raney EM. Pin-tract infection during limb lengthening using external fixation. Am J Orthop (Belle Mead NJ). 2008 Sep;37(9):E150–E1544.
3. Battle J, Carmichael KD. Incidence of pin track infections in children’s fractures treated with Kirschner wire fixation. J Pediatr Orthop. 2007 Mar;27(2):154–157. doi: 10.1097/bpo.0b013e3180317a22.
4. Jennison T, McNally M, Pandit H. Prevention of infection in external fixator pin sites. Acta Biomater. 2004 Feb;10(2):595–603.
5. Ilizarov GA. The tension-stress effect on the genesis and growth of tissues Part I. The influence of stability of fixation and soft-tissue distraction. Clin Orthop. 1989 Jan;238: 249-81.
6. Ilizarov GA. The tension-stress effect on the genesis and growth of tissues Part II. The influence of the rate and frequency of distraction. Clin Orthop. 1989 Feb;239: 263 - 85.
7. R Rose. Complications of Femoral Lengthening using the Ilizarov Fixator. The Internet Journal of Orthopedic Surgery. 2008 Volume 15 Number 1.
8. C Sen, L Eralp, T Gunes, M Erdem, V.E. Ozden, M Kocaoglu. An alternative method for the treatment of non-union of the tibia with bone loss. J Bone Joint Surg Br. June 2006;88: 783-9.
9. Axel P, Gert M, Andreas D. Hydroxyapatite-coated schanz pins in external fixators used for distraction osteogenesis; A randomized controlled trial. J Bone Joint Surg Am 2002;Jul 84:1162-6.
10. Holbrook, JL, Swiontkowski, MF, Sanders R. Treatment of open fractures of tibial shaft: Ender nail versus External fixation. A Random, Prospective comparison. J Bone Joint Surg Am. 1989 Sep;71:231-1238.
11. Pasha IF, Qayyum A, Tanveer K, Mehboob I, Siddque A, Ahmed A. Segment transport Using Unilateral Fixator; (locally Made Naseer Awais Fixator). J Pak Orthop. Assoc. 1998;10 (2): 10-21.
12. Kenneth AE, Nader P, Steven P, Jeffrey K, Rudi H, Kenneth JK. Treatment of External Fixation Pins About the Wrist: A Prospective, Randomized Trial. J Bone Joint Surg Am. 2006 Feb; 88: 349-354.
13. Saleh M, Scott BW. Pitfalls and complications of leg lengthening, the Sheffield experience. Seminar in Ortho 1992 Jan;3:207-22.
14. Sahibzada AS, Kham MA and Khan MS. Management of Tibial Bone Defects due to High Energy Trauma Using the Locally Manufactured External fixator by Segmental Transport. J Ayub Med Coll Abottabad 2005 Jul-Sep;17(3).
15. Paley D, Maar DC. Ilizarov bone transport treatment for tibial defects. J Orthop trauma. 2000 Feb;14(2):76-85.
16. Danziger MB, Kumar A, DeWeese J. Fractures after femoral lengthening using Ilizarov method. J Paediatr Orthop. 1995 Mar-Apr;15(2):220-23.
17. Caudel RJ, Stern PJ. Severe open fractures of the tibia. J Bone Joint Surg. 1987 Jul;69A:801-807.
18. Fix RJ, Vasconez LO. Fasciocutaneous flaps in reconstruction of the lower extremity. Clin Plast Surg. 1991 Jul;18:571-582.

Downloads

Published

2018-04-09

Issue

Vol. 30 No. 01 (2018): Journal of Pakistan Orthopaedic Association

Section

Original Articles

How to Cite

Common Complications of Ilizarov External Fixator. (2018). Journal of Pakistan Orthopaedic Association, 30(01), 39-43. https://jpoa.org.pk/index.php/upload/article/view/201

Similar Articles

1-10 of 65

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)