Management of high energy proximal tibial fractures by Ilizarov external fixator / Khaled Mohammed Abdelmooty Elsisy ; Supervised Hazem Abdelazeem , Ahmed Nabawy Morrah , Mohamed Mahmoud Hegazy

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopaedic Surgery

Background: Despite the evolution of surgical techniques and implants, high energy proximal tibia fractures remain a challenging problem. The goals of treatment are to obtain a well-aligned stable joint with a painless functional range of motion and prevention of posttraumatic arthritis. Indirect reduction techniques and other soft tissue preservation methods safeguard the vascularity and emphasize restoring both joint congruity and the mechanical axis of the limb. Aim of the work: is to evaluate the use of circular hybrid Ilizarov external fixator with or without minimal internal fixation in the management of high energy proximal tibial fractures. Methods: between March 2011 and March 2013 we treated 30 patients with high energy proximal tibia fractures including extra- and intra- articular fractures using the Ilizarov fixator, all patients were a result of high energy trauma. There were 23 male patients and 7 female patients, 14 were Right side while 16 were Left side, mean age was 36.2 years, there were 17 cases with open fractures and 13 patients had closed fractures, 21 patients had intraarticular fractures and 9 patients had extraarticular fractures. Results: all patients united in a mean time of 19 weeks, we had 9 patients with few complications that have been well treated. According to ASAMI scoring system we had excellent results in 66.7%, good results in 26.7%, fair results in 6.6% and no poor results. Conclusion: Ilizarov external fixation is a safe and effective treatment option for high energy proximal tibia fractures with good functional results

Issued also as CD