Distal Tibial Fracture Managed by Circular External Fixation: Clinical and Functional Outcomes
DOI:
https://doi.org/10.61919/jhrr.v4i3.1348Keywords:
Distal Tibial Fracture, Circular External Fixation, Ilizarov TechniqueAbstract
Background: Distal tibial fractures, often resulting from high-energy trauma, pose significant challenges in orthopedic management due to their complexity and associated soft tissue injuries. Circular external fixation, particularly the Ilizarov technique, has emerged as a treatment option that offers the potential for enhanced fracture stability and preservation of soft tissue integrity.
Objective: To evaluate the functional and clinical outcomes of distal tibial fractures managed by circular external fixation using the Ilizarov technique.
Methods: This prospective study was conducted from September 2023 to May 2024 at the Department of Orthopedics, Hayatabad Medical Complex, Peshawar. Sixty patients aged 18 years or older with distal tibial fractures were included. Patients with diabetes, pregnancy, or age over 60 years were excluded. The fractures were treated using the Ilizarov fixator technique by an experienced surgeon. Postoperative assessments included functional outcomes using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria and pain evaluation using the Visual Analog Scale (VAS). Radiographic assessments were performed to evaluate malunion and nonunion. Data were analyzed using SPSS version 25, with descriptive statistics summarizing demographic data and paired t-tests used for comparing preoperative and postoperative pain scores, with significance set at p < 0.05.
Results: The mean age of the patients was 41.10 ± 12.74 years, with a mean BMI of 25.07 ± 1.88 kg/m². Males constituted 76.7% of the cohort. The majority of injuries were due to road accidents (51.7%). Functional outcomes showed that 63.3% of patients had excellent results, 18.3% had good outcomes, 15.0% had fair outcomes, and 3.3% had poor outcomes. A significant reduction in pain was observed, with the mean VAS score decreasing from 7.47 ± 0.999 preoperatively to 2.47 ± 0.982 postoperatively (p = 0.0001). Complications were minimal, with 13.3% experiencing infections, 1.7% malunion, and 3.3% nonunion.
Conclusion: Circular external fixation using the Ilizarov technique for distal tibial fractures led to favorable clinical and functional outcomes, with significant pain reduction and minimal complications. This technique should be considered a viable option for managing complex distal tibial fractures, particularly in cases requiring soft tissue preservation.
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Copyright (c) 2024 Muhammad Saeed, Muhammad Inam, Shafi Ul Haq, Israr Ahmad
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