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.

The "foothill" entry for cephalomedullary nailing in unstable proximal femoral fractures: a technical note with a review of the literature.

Cephalomedullary nailing for unstable proximal femoral fractures is widely utilized, especially for geriatric osteoporotic fractures. There are two starting points for entry, namely trochanteric tip entry and pyriformis fossa entry, both have advantages and disadvantages, the tip of the greater trochanter seems that it is not the ideal starting point for trochanteric entry nails, the study presents the foothill entry point as a reproducible, technically feasible entry point to overcome the shortcoming of both standard starting points, and it could be easy executed with clear intraoperative fluoroscopic landmarks and lead to appropriate nail position without intraoperative complications.

Ilizarov-Assisted Healing for a Neglected Non-united Fracture Calcaneus: A Case Report and Literature Review.

Although calcaneal fracture is not a rare injury and nonunion is rare, proper management of a calcaneal fracture is mandatory because it can be a prerequisite for long-term functional disabilities of the foot, including posttraumatic osteoarthritis of the hindfoot joint, chronic pain, and persistent swelling syndromes. Restoration of axial alignment and joint congruence with careful caution toward soft tissues is the basic principle of treatment; however, few literature reviews to date have addressed the characteristics of a calcaneal nonunion fracture. We discuss a case of a 30-year-old male, manual worker, and diabetic type 1 with a calcaneal fracture reaching the articular surface of the subtalar joint who underwent a simple fracture to a painful nonunion fracture after conservative treatment for seven months before presenting to our hospital being unable to walk with heel deformity. The Ilizarov frame was used to correct deformities in the hindfoot, enhance healing by compressing the fracture site, and allow early weight bearing with the maintenance of subtalar joint function. Our result demonstrates increased calcaneal healing when the Ilizarov foot frame is used, and when the calcaneal fracture site is compressed, this is a good option for maintaining foot and ankle function, even in diabetic patients.