Comparative outcome study of the management of open tibia shaft fractures using Ilizarov frame fixator and linear rail system at University College Hospital, Ibadan, Nigeria.

BACKGROUND

Management of Open tibia shaft fractures utilizing the conventional protocol is usually cumbersome; involves several operative procedures and longer periods of hospitalization. The use of external fixators for the definitive management of open tibia shaft fractures has been promising. The Ilizarov frame and linear rail system (LRS) are the commonly used options since they are comparable in efficacy and adaptable in the management of open tibia shaft fractures. The study objective is to determine and compare for any significant difference in the mean radiological union time, union rate, bone outcomes and functional outcomes noted in the management of patients with open tibia shaft fractures using Ilizarov frame fixator and linear rail system (LRS) in Ibadan, Nigeria.

RESEARCH METHOD: This is a prospective study involving thirty (30) patients of both sexes, divided into two (2) groups; Ilizarov frame fixator group and LRS group. All patients had open tibia shaft fractures of Gustillo-Anderson Class (GA II- IIIB). The radiological union time was derived from the length of time in the fixator during which radiological union was confirmed, while the bone and functional outcomes were assessed using the ASAMI criteria.

RESULT: Union was achieved in 27 participants while three (2 in LRS group and 1 in Ilizarov group) had non-union. The union rate was 86.7% for the LRS group and 93.3% for the Ilizarov group. The mean radiological union time was 6.5 ± 1.8 months in the LRS group and 6.4 ± 2.1 months in the Ilizarov group. The bone outcomes showed that in the LRS group, 66.7% had excellent, 20% had good and 13.3% had poor outcomes while the Ilizarov group had 53.3% excellent, 40% good and 6.7% poor outcomes. The functional outcome showed that in the LRS group 53.3% had excellent, 40% good and 6.7% fair outcomes while in the Ilizarov group, 40% excellent, 46,7% good and 13.3% fair outcomes. There is no significant difference noted in the mean radiological union time, union rate, bone and functional outcomes in the management of these open tibia shaft fractures using the two fixators under review.

CONCLUSION

The study has re-iterated the fact that the Ilizarov frame fixator and the LRS are quite versatile tools in the armamentarium of the orthopaedic surgeon for managing open tibia shaft fractures.