Outcome of Ilizarov Fixator in the Management of Proximal Tibial Fractures in Adults

Abstract

Background:
Proximal tibial fractures are complex peri-articular injuries that threaten joint stability and function. Their management is often complicated by soft-tissue compromise and comminution. Conventional open reduction and internal fixation (ORIF) can result in wound breakdown and infection. The Ilizarov external fixator offers a minimally invasive alternative that provides stable fixation, preserves blood supply, and allows early rehabilitation.

Objective:
To evaluate the functional and radiological outcomes of the Ilizarov fixator in the management of proximal tibial fractures among adult patients.

Methods:
A descriptive study was conducted in the Department of Orthopedic Surgery, Recep Tayyip Erdogan Hospital, Muzaffargarh, Pakistan. A total of 107 adults (25–65 years) with proximal tibial fractures of ≤ 7 days’ duration were treated using the Ilizarov technique. Functional outcomes were assessed at 24 weeks post-operation using the Rasmussen Functional Knee Score, while radiological union was evaluated by X-ray at six months. Data were analyzed with SPSS v23 using descriptive statistics and chi-square tests to explore associations between demographic factors and outcomes.

Results:
Radiological union was achieved in 98.1 % of cases. The mean Rasmussen score was 27.55 ± 2.96, with 71 % of patients showing excellent, 22 % good, 4.7 % fair, and 1.9 % poor outcomes. No statistically significant association was found between functional outcome and variables such as obesity, smoking, diabetes, or mechanism of injury (p > 0.05).

Conclusion:
The Ilizarov fixator is an effective and safe modality for managing proximal tibial fractures, providing high union rates, excellent functional outcomes, and minimal complications. Its minimally invasive nature and adaptability make it a preferred first-line treatment in complex fractures, particularly where soft-tissue preservation is critical.