Anil Joshi1, Saurabh Singh2, Sudeep Jain3, Narender Rohilla4, Vivek Trikha5, Chandra Yadav5. 1. Medical College, V.C.S.G. Government Medical Sciences and Research Institute, Srinagar, Pauri Garhwal, India; H.N.B. Base & Teaching Hospital, P.O.-Srikot, Srinagar, Srinagar Garhwal, Uttarakhand 246174, India. 2. Department of Orthopaedics, IMS BHU, Varanasi, India, Varanasi, Uttar Pradesh 221005, India. 3. Fortis Flt Lt Rajan Dhall Hospital, Ringgold Standard Institution, Safdarjung Enclave, New Delhi, Delhi 110070, India. 4. Fortis Hospital, Shalimar Bagh Ringgold Standard Institution, Safdarjung Enclave, New Delhi, Delhi 110033, India. 5. Department of Orthopaedics, All India Institute of Medical Sciences Ringgold Standard Institution, New Delhi, Delhi 110029, India.
Abstract
BACKGROUND: The present study aimed to compare outcome of primary and secondary Illizarov's fixator application as a treatment method for type III open tibial fractures in terms of non-union and wound infection. METHODS: This prospective study was done in a tertiary care center. Forty-eight type III tibial fractures were treated with Illizarov's apparatus between 2008 and 2011. The patients were divided into two groups depending on the treatment protocol, timing of wound closure and Illizarov's application, primary (n=28) and secondary (n=20). RESULTS: In the primary group, healing was achieved in all 28 patients. The median time to recovery was 24 weeks, and the median number of operations was 3. There were 6 patients with a bone defect. In the secondary group, complete recovery was achieved in 18 out of 20 patients. The median time to recovery was 30 weeks, and the median number of operations 5. There were 9 patients with a bone defect. The median time to recovery and the number of operations were significantly smaller in patients undergoing primary operation. Union was 100% in the primary group and more than 95% in the secondary group. Chronic osteomyelitis persisted in one patient and below amputation was done in one patient in the secondary group. CONCLUSION: Primary wound closure and Illizarov's fixation required a smaller number of operations and shorter time to recovery than secondary wound closure and Illizarov's fixation, mostly due to a significantly less number of patients with a bone defect in the primary group.
BACKGROUND: The present study aimed to compare outcome of primary and secondary Illizarov's fixator application as a treatment method for type III open tibial fractures in terms of non-union and wound infection. METHODS: This prospective study was done in a tertiary care center. Forty-eight type III tibial fractures were treated with Illizarov's apparatus between 2008 and 2011. The patients were divided into two groups depending on the treatment protocol, timing of wound closure and Illizarov's application, primary (n=28) and secondary (n=20). RESULTS: In the primary group, healing was achieved in all 28 patients. The median time to recovery was 24 weeks, and the median number of operations was 3. There were 6 patients with a bone defect. In the secondary group, complete recovery was achieved in 18 out of 20 patients. The median time to recovery was 30 weeks, and the median number of operations 5. There were 9 patients with a bone defect. The median time to recovery and the number of operations were significantly smaller in patients undergoing primary operation. Union was 100% in the primary group and more than 95% in the secondary group. Chronic osteomyelitis persisted in one patient and below amputation was done in one patient in the secondary group. CONCLUSION: Primary wound closure and Illizarov's fixation required a smaller number of operations and shorter time to recovery than secondary wound closure and Illizarov's fixation, mostly due to a significantly less number of patients with a bone defect in the primary group.
Entities:
Keywords:
Debridement; Illizarov’s fixator; Limb salvage; Open fractures; Tibial fractures
Authors: R R Keen; J P Meyer; J R Durham; J Eldrup-Jorgensen; P Flanigan; T H Schwarcz; J J Schuler Journal: J Vasc Surg Date: 1991-05 Impact factor: 4.268