The Ilizarov method of external fixation: current intraoperative concepts.

The Ilizarov method of external fixation is used to treat fractures, complex lower extremity deformities, osteomyelitis, and soft tissue contractures and to lengthen limbs. Tremendous improvements in the Ilizarov method have occurred during the past 60 years, improving intraoperative care and limb salvage management concepts. Improved instrumentation has increased the quantity and complexity of the tray systems required for these procedures. Perioperative nurses must be well versed in optimal preparation and function of Ilizarov fixation systems to ensure safe patient care during Ilizarov external fixation procedures.

Postoperative impact of daily life after primary treatment of proximal/distal tibiafracture with Ilizarov external fixation.

AIMS AND OBJECTIVES: To describe patients' experience of the impact of their health-related life situation on their daily life two and four weeks after primary fracture treatment with Ilizarov external fixation. BACKGROUND: A few studies have been conducted postoperatively focussing on fracture treatment with Ilizarov fixation. DESIGN: A prospective descriptive research design. METHOD: Patients who had been treated for a proximal/distal tibial fracture were invited to participate in the study. Data were collected with a semi-structured questionnaire where 20 patients described in their own words their situation at home two and four weeks postoperatively. The process used when analysing the data was similar to content analysis. RESULTS: Four key themes were identified: 'limitations in the home environment', 'limitations outside the home', 'limitations to social relations' and 'experience of having an Ilizarov fixation'. The patient's life situation was strongly affected during the first postoperative month. This took the form of clear limitations on activities outside the home and a degree of limitation on coping with household chores and personal hygiene. These limitations became less severe after between 2-4 weeks and were very much a consequence of using crutches. CONCLUSION: This study points to limitations in the patient's daily life situation in the home. The results from the study make it obvious that the information given to patients prior to discharge, concerning the value of putting weight on the leg, had not been clear or that the patients had not understood it. This had a negative impact on the patient's daily life after discharge. Further data are needed to uncover the extent of the issue to be able to optimise patient outcomes. RELEVANCE TO CLINICAL PRACTICE: There is a need for clearer and more active information from the nurse before discharge but also a need to follow up how the information given is understood.

The principles of caring for patients with Ilizarov external fixation.

External fixation is an important aspect of complex fracture management. Ilizarov fixation is a specialised type of external fixator consisting of numerous wires that penetrate the limb and are attached to a circular metal frame. Ilizarov fixation is used for fracture fixation and stabilisation, limb reconstruction, deformity correction and limb lengthening. The external fixator can be in place for many months and patients will need to adapt to the device and demonstrate an understanding of the principles of pin site care. Psychosocial issues also need to be considered.

Reflections of a novice researcher.

Nurses can benefit from active participation in research activities. Involvement in research is not just an academic pursuit but is essential for effective, quality care. Nurses should actively seek the support of colleagues and research support structures to enable involvement in research. Clinical nurses are capable of making an important research contribution.