Evaluation of Ilizarov technique in the treatment of open fractures of tibia

Debdulal Debnath, Jihadul Islam, Nazmul Huda, M. A. A. Shameem


Background: Now a day, open fracture of tibia is a common occurrence in the orthopedic treatment arena. Fundamentally, open fractures of tibia are classified into type I, II, IIIA, IIIB and IIIC. The aim of this study was to evaluate the Ilizarov technique in the treatment of open fractures of tibia.

Methods: This was an observational prospective study conducted in the Department of Orthopedic Surgery, Northern International Medical College& Hospital, Dhaka, Bangladesh during the period from January 2017 to December 2017. Thirty-six (36) patients with tibial fractures were selected as the study population. This study was approved by the ethical committee of the respective medical college.

Results: Out of total 36 participants, 65% were males and 35% were female. In analyzing mode of injuries, we found the highest 80.56% participants were from road accidents followed by 11.11% from sports injury and rest only 8.33% from general falls. The duration of treatment with the fixator was 12-23 weeks (average 16 weeks). In our study total 36 cases were debrided on the same day and stabilized with Ilizarov ring faxator after a period of 5 to 12 days from the date of injury. The operation time ranged from 90 minutes to 120 minutes (Mean 102±4 minutes).  

Conclusions: In this study no case developed deep infection, non-union or unacceptable mal-union. The construct through Ilizarov is stable and enables the patient to bear weight on the affected limb a short time after the surgery, even in cases of comminuted fractures.


Illizarov, Tibial fractures, Proximal, Distal, Fixator

Full Text:



Cannada LK, Anglen JO, Archdea MT, Herscovici D, Ostrum RF. Avoiding complications in the care of fractures of the tibia. Instr Course Lect. 2009;58:27-36.

Whittle AP, Wood ІІ GW. Fractures of lower extremity. In: Canale ST. Campbell’s operative orthopaedics. 10th ed. Philadelphia, 2003;2754-73.

Webb LX, Bosse MJ, Castillo RC, MacKenzie EJ. LEAP Study Group. Analysis of surgeon-controlled vari- ables in the treatment of limb threaten- ing type-ІІІ open tibial diaphyseal frac- tures. J Bone Joint Surg. 2007;89:923-28.

Petrisor BA, Bhandari M, Schmitsch E. Tibia and fibula fractures. In: Bu- cholz RW, Court-Brown CM, Heck- man JD, Tornetta ІІІ P. Rockwood and Green’s fractures in adults. 7th ed. Philadelphia; Lippincott Williams & Wilikins; 2010: 1867-1923.

Wani N, Baba A, Kangoo K, Mir M. Role of early Ilizarov ring fixator in the definitive management of type ІІ, ІІІA and ІІІB open tibial shaft frac- tures. Int Orthop. 2011;35:915-23.

Hasankhani E, Payvandi MT, Bir- jandinejad A. The Ilizarov ring ex- ternal fixator in complex open frac- tures of the tibia. Eur J Trauma. 2006;32:63-8.

Papaioannou N, Mastrokalos D, Papagelopoulos PJ, Tyllianaksi M, Athanassopoulos J, Nikiforidis PA. Nonunion after primary treatment of the tibia fractures with external fixa- tor. Eur J Orthop Surg Traumatol. 2001;11:231-35.

Gustilo RB. Management of open fractures, in Gustilo RB (Ed.). Orthopaedic Infection, diagnosis and treatment, 1st edition (Philadelphia:WB Saunders Company, 1989) 87-9.

Kim PH. Leopold S. Gustilo-Anderson Classification. Clin Orthop Relat Res. 2012;470(11):3270-4.

Ali MZ, Sultana N, Reza MH. Patterns of Tibial Open Fractures Treated by Illizarov Technique: A study in a tertiary care hospital.

Trafton PG. Tibial shaft fractures, in Browner BD, Jupiter JB, Levine AM, Krettek C (Eds.). Skeletal trauma: basic science, management and reconstruction, 4th edition, 1998;2:2319-451.

Golyakhovsky V, Frankel VH. Operative manual of Ilizarov techniques, (New Delhi: Jaypee Brothers, 1986).

Shtarker H David R, Stolero J, Grimberg B, Soundry M. Treatment of open tibial fractures with primary suture and Ilizarov fixation, Clinic Orthopaed Relat Resear. 1997;335:268-74.

Tucker HL, Kendra JC, KInnebrew TE. Management of unstable open and closed tibial fractures using Ilizarov method, Clinic Orthopaed Relat Resear. 1992;280:125-35.

Keating JF, Obrier PF, Blachut PA, Meck RN, Broekhuse HM. Locking intramedullary nailing with and without reaming for open fracture of the tibial shaft. J Bon Join Surg. 1987;79:334-41.

Hulth A. Basic science and pathology, current concept of fracture healing. Clinic Orthopaed Relat Resear. 1989;249:265-85.

Holbrook JL, Swiontkowski MF, Sanders R. Treatment of open fractures of the tibial shaft: Ender nailing versus external fixation. A randomized, prospective comparison. J Bon Join Surg. 1989;71(8):1231-8.