Objective: To evaluate the functional and radiological outcomes of the Ilizarov method in the management of tibial gap nonunion.
Methodology: This retrospective cohort, descriptive study was performed at Dr. Ruth K.M. Pfau Civil, Hospital, Karachi, Pakistan, on patients 15-65 years of age, presenting with tibial gap nonunion from December 2016 to 2018. All patients underwent management with the Ilizarov technique. Functional and bone outcomes were evaluated according to the Association for the Study and Application of Methods of Ilizarov criteria.
Results: Out of 36 patients, 28 were males and 8 females, with a mean age of 33.25±10.12 years. All patients achieved union, with a mean duration of 22.1±10.7 weeks. The mean time from referral to the application of the framework was 18.6±6.2 weeks. Compression was performed in 15 while compression-distraction in 19. In two patients, compression plus bone transport was done, while bone grafting was required in two. The average bone gap was 1.7±1.2 cm. Pin-tract infection was found in seven patients, buckling at docking site in one, and ankle stiffness in four. The functional outcome was good in 64%, the radiological outcome was excellent in 31%, while good in 58%.
Conclusion: The Ilizarov method of osteosynthesis is an effective technique in the management of complex infected and aseptic non-union fractures of the tibia to achieve a satisfactory functional and radiological outcome. The presence of infection may have delayed bone healing however; the bony union was achieved in all.
Key words: Tibial fractures, Ilizarov technique, osteosynthesis.