The Ilizarov fixator in trauma: a 10-year experience

We reviewed the clinical results of 332 fractures treated with the Ilizarov external fixator between 1984 and 1993. The locations of the involved bones were: tibia, 247 (including 28 with tibial pylons); femur, 47; humerus, 21; forearm, 12 and calcaneus, 5. The clinical outcomes of this series were retrospectively evaluated by radiological and clinical rating systems. In the tibial fractures, results in 71.1% were categorized as excellent or good, without deep infection; 63.3% of the tibial pylon fractures, mostly open, also showed excellent or good results. In the femoral fractures, which were mostly localized at the metaphysis or distal epiphysis, 72% showed excellent or good results, but the patients commonly complained of knee stiffness. Limitations of range of movement (ROM) in the elbow and the wrist were common in patients with forearm fracture, but ROM was regained after physical therapy. According to the clinical results of the present study, we believed that Ilizarov external fixation was best indicated for tibial fractures, because of its advantage of allowing early weight-bearing. Ilizarov external fixation was also best indicated for: (1) open fractures, (2) comminuted fractures, (3) intra-articular fractures, and (4) fractures with bony defect.