Mid-term Results of Distal Tibial Fractures Treated with Ilizarov External Fixator

ABSTRACT

PURPOSE: We analyed the mid-term results of distal tibial fractures treated with ilizarov external fixator and functional results according to delayed metaphyseal healing and fracture pattern. MATERIALS AND METHODS: We reviewed 23 distal tibial fractures treated with ilizarov external fixator followed for minimum two year (mean 53 months). There were 10 A fractures, 2 B fractures, and 11 C fractures according to the AO classification. Radiographically, we analyzed bony union time according to translation of diaphyseal-metaphyseal fracture line and assessed arthritic score. Functional results was assessed with AOFAS score and analyzed according to delayed healing and fracture pattern. RESULTS: Average union time was 21 weeks. Delayed healing of metaphyseal fracture line was associated translational displacement >3 mm (p=0.01). AOFAS scrore was averaged to 68 and there was no stastical significance between delayed metaphyseal healing and functional results (p=0.31). But, low AOFAS score and arthritis score was related to fracture type (p=0.02). In 11 C fractures, radiographic arthritic change were developed in 6 cases (55%). CONCLUSION: The main prognosis of distal tibial fractures depends on articular involvement and to shorten the external fixation time, metaphyseal fracture should be reduced within 3mm.