genortГений ортопедииGenij Ortopedii1028-44272542-131XЦЕНТР ИЛИЗАРОВА10.18019/1028-4427-2025-31-2-143-152genort-3201Research ArticleОригинальные статьиOriginal articlesОкончательная фиксация открытых переломов большеберцовой кости с использованием кольцевых аппаратов Илизарова — анализ функциональных результатовDefinitive fixation of open tibial fractures using the Ilizarov ring fixator: an analysis of functional outcomeshttps://orcid.org/0000-0002-0181-479XRadhakrishnanE.RadhakrishnanE.

Ezhilmaran Radhakrishnan — Senior Assistant Professor, Department of Orthopedic Surgery

Tamilnadu

Ezhilmaran Radhakrishnan — Senior Assistant Professor, Department of Orthopedic Surgery

Tamilnadu

ezhilmars@yahoo.co.inhttps://orcid.org/0009-0009-0229-6312DuraisamyE.DuraisamyE.

Duraisamy Ezhilmaran — Assistant Professor, Department of Orthopedic Surgery

Tamilnadu

Duraisamy Ezhilmaran — Assistant Professor, Department of Orthopedic Surgery

Tamilnadu

ezhilmarand@gmail.comGovernment Chengalpattu Medical CollegeИндияGovernment Chengalpattu Medical CollegeIndia202521042025312143152Copyright © Radhakrishnan E., Duraisamy E., 20252025Radhakrishnan E., Duraisamy E.Radhakrishnan E., Duraisamy E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ilizarov-journal.com/jour/article/view/3201Введение

Введение. При открытых переломах большеберцовой кости обычно применяют первичную хирургическую обработку раны и временную стабилизацию внешними фиксаторами АО с последующей отсроченной внутренней фиксацией при условии адекватного состояния мягких тканей и отсутствия инфекции.

Цель работы — выявление факторов, влияющих на результат лечения пациентов с открытыми переломами большеберцовой кости с использованием внешней фиксации аппаратом Илизарова в качестве окончательного метода.

Материал и методы

Материал и методы. В исследование включены 28 пациентов обоих полов в возрасте старше 18 лет с открытыми переломами большеберцовой кости. Открытые переломы систематизировали в соответствии с классификацией открытых переломов Gustilo – Anderson. Скелетную стабилизацию осуществляли либо кольцевыми аппаратами Илизарова, либо наружными фиксаторами АО, которые в течение пяти дней после травмы при тщательной хирургической обработке ран меняли на аппарат Илизарова. Результаты оценивали через 4 недели после окончательной операции, затем через 6 недель, 3 месяца, 6 месяцев и через 1 год. Результаты анализировали с использованием критериев Tuckers.

Результаты

Результаты. Сращение без инфекции достигнуто у 25 пациентов. Три пациента исключены из последующего наблюдения.. У большинства пациентов (48 %) сращение произошло через 24  недели. У  10  пациентов возникла спицевая инфекция в месте установки. Функциональный результат изучали с  использованием критериев Tuckers, согласно которым у 5 пациентов (20 %) результат оценен как  отличный, у 9 пациентов (33 %) — хороший, у 8 пациентов (29 %) — удовлетворительный и у 3 (16 %) — плохой.

Обсуждение

Обсуждение. Ограничениями данного исследования являются отсутствие группы сравнения и недостаточно длительный период наблюдения за пациентами (в течение одного года).

Заключение

Заключение. Окончательная фиксация открытых переломов большеберцовой кости, особенно переломов типа 3В, аппаратом Илизарова является оптимальным и экономически эффективным методом лечения.

Introduction Open tibial fractures are generally managed by wound debridement and temporary stabilisation with AO external fixators followed by delayed internal fixation provided the soft tissue cover is adequate and there is no infection. This study aims at analysing the factors influencing the outcome of treatment of open tibial fractures using external fixation with Ilizarov ring fixators as definitive method.

Materials and methods Twenty eight patients of both sexes aged more than 18 years who presented with  open tibial fractures were included as our study subjects. The open fractures were classified according to  Gustilo‑Anderson classification of open fractures. Skeletal stabilisation was done either with Ilizarov ring fixators primarily or with AO external fixators in whom within 5 days since the injury the Ilizarov ring fixators were applied after thorough debridement of wounds. Patients were followed up first 4 weeks after the definitive procedure, then after 6 weeks, 3 months, 6 months and 1 year. The results were analysed using Tuckers criteria.

Results We achieved union in 25 patients without infection. Three patients were lost for follow-up. In  majority of  patients (48 %) union occurred in 24 weeks. In 10 patients we had pin site infections. The  functional outcome was studied using Tucker’s Criteria according to which 5 patients (20 %) had excellent outcomes, 9 patients (33 %) had good outcomes, 8 patients (29 %) had fair outcomes and 3 (16 %) had poor outcomes.

Discussion Limitation of the present study is the absence of a comparison group, though it was possible because of the nature of the injuries that these patients had while arriving at the trauma care facility. Another limitation is the follow-up period. We followed the patients for one year but if we followed the patents for longer periods we could have assessed the long-term prognosis.

Conclusion The definitive treatment of open tibial fractures especially Type 3B fractures with the Ilizarov Ring Fixator system is found be optimal and cost-effective.

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The authors declare that there are no conflicts of interest present.