[Treatment of problem fractures with the Ilisarow procedure. Minimally invasive fixation technique and callus distraction].

Between march 1990 and december 1992, 19 patients with compound fractures were treated with Ilisarow's external fixator at the Department of Traumatology of the University of Ulm. The device was applied as a primary implant in 7 patients, most of whom showed fractures of infectious cavities or refractures in a latent state of infection. 12 patients were stabilized with a change to the ringfixator in secondary fracture treatment during 4 weeks after trauma. 5 of these patients suffered of acute osteomyelitis after internal fracture fixation, 3 patients had metaphyseal fractures and in four cases extensive bone defects were filled by callotasis. Treatment could be completed with the ring device in 16 patients whereas in 3 patients a change to internal fixation had to be performed due to delayed union or atrophic pseudarthrosis. The main disadvantages of this system consisted in the comparatively time consuming operative procedure and limited comfort for the patient. Nevertheless, Ilisarow's device has proved to be an useful tool in the treatment of compound fractures or fracture treatment under poor biological conditions due to its minimal invasive fixation technique.