Treatment of infected tibial nonunions by Ilizarov

Infected ununited tibial fractures has haunted orthopedic surgeons for long times. Several treatment options have been tried and Ilizarov fixator is now one of the commonest used modalities for such problem. In this study we assessed the results of treatment of infected united tibial fractures using the Ilizarov fixator. We prospectively studied 28 infected unuitted tibial fractures in 28 patients. Three techniques were used: Acute compression, acute compression and lengthening and bone transport followed by compression. The results were assessed according to the system adopted by Paley et al. Healing of the non-union site and eradication of infection was achieved in 27 cases [97%]. The use of the Ilizarov fixator is a very good method for treatment of infected ununited tibial fractures

Correction of complex foot deformities after skeletal maturity using the Ilizarov external fixator

There are many drawbacks to the use of conventional approaches in treating complex foot deformities especially after skeletal maturity, like the increased risk of neurovascular injury, soft-tissue injury, major skin problems, and the shortening of the foot. An alternative approach that can eliminate these problems is the Ilizarov method. In the current study, a total of 13 severely deformed feet in 12 patients [all had equines, varus and metatarsus adductus] were treated using the Ilizarov method. The etiologic factors were neglected and relapsed clubfeet, post traumatic cases and poliomyelitis. The patient's mean age was 24.5 [20-39] years. We performed corrections without osteotomies or soft tissue releases using a bloodless technique. The mean duration offixator application was 4.6 [3.5-6] months. At the time offixator removal, a plantigrade foot was achieved in all feet however additional bony corrective procedures after frame removal included one case of tibial osteotomy and one tibiotalar arthrodesis in another case. During our follow up we took into consideration previos daily activity which was mandatory as one of our patients had the walking distance much decreased due to pain. Follow-up time after cast removal averaged 32 months [26-40]. Complications other than pin-tract infections were toe contractures in two feet, metatarsophalangeal subluxation from flexor tendon contractures in one foot, mild relapse of equines deformity in three feet and pain due to different causes. We consider the Ilizarov method to be an effective alternative means of correcting complex foot deformities, especially in feet that had undergone several previous surgeries