Radiographic and functional results of Ilizarov fixation in the management of nonunion of tibia and femur fractures: a retrospective case series.

BACKGROUND: Femoral and tibial fractures may result in delayed union and nonunion, posing significant challenges in orthopedic practice. The Ilizarov technique has emerged as a promising solution for managing these complex cases. OBJECTIVES: Evaluate the radiographic and functional results of Ilizarov fixation in the treatment of nonunion of tibia and femur fractures. DESIGN: Retrospective. SETTINGS: Hospitals affiliated with a university hospital. PATIENTS AND METHODS: Patient demographics, fracture characteristics, and treatment details were analyzed for the period from October 2015 to September 2022 in patients who were treated for nonunion of the tibia and femur using the Ilizarov fixator. Clinical and radiological assessments were performed using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria. The study focused on assessing the average duration for union and frame removal, bone results, successful union rates, and functional results using the ASAMI criteria, obtaining data from the existing medical records, spanning various medical facilities treating nonunion fractures. SAMPLE SIZE: 126 patients. RESULTS: The average duration for union and frame removal was 8 months, with excellent bone results observed in 60.32% of cases. Out of 126 patients, 118 achieved successful union, while there were 2 failure cases necessitating amputation (1.52%). Functional results revealed excellent outcomes in 39.68% of cases. Complications included pin tract infections, ankle and knee stiffness, and limb shortening. External fixation duration and infection eradication were consistent with previous research, emphasizing the technique's effectiveness. CONCLUSIONS: The Ilizarov technique proved highly effective in managing nonunion tibia and femur fractures, offering favorable outcomes in terms of union, infection control, pain relief, and functional recovery. While excellent bone outcomes do not guarantee optimal function, this method remains a reliable approach for complex cases. LIMITATIONS: Potential biases inherent in retrospective analyses and the need for further randomized controlled trials to comprehensively compare treatment modalities.

Treatment of non-displaced intracapsular femoral neck fractures with dynamic hip and cannulated screws resulting in avascular necrosis: A comparative study of complications.

OBJECTIVES: To compare the complications associated with cannulated hip screws (CHS) and dynamic hip screws (DHS) techniques. METHODS: In this multicenter retrospective chart study, we reviewed the records and data of all patients operated upon by DHS or CHS for treatment of Garden type I and type II intracapsular non-displaced femoral neck fracture from January 2017 to December 2022. Patients with incomplete files or follow-ups of less than one year were excluded from the study. RESULTS: The study enrolled 85 patients, 35 males, and 50 females, with a mean age of 72±5.4 for males and 70.6±7.6 for females. A total of 44 patients were operated upon with DHS, and 41 patients with CHS. The mortality rate of DHS was 15.9% and was 17.1% in the CHS group (p>0.05). Non-union was recorded in 4.5% of the DHS group and 4.9% of CHS patients (p>0.05). Avascular necrosis (AVN) was significantly higher in DHS (9.1%) than in CHS (4.9%, p<0.05). A revision was required in 15.9% of DHS patients and 14.6% of CHS patients (p>0.05). CONCLUSION: This study found that DHS was superior to CHS in AVN rate. However, there was no significant difference between both methods regarding mortality, revision, and non-union.