Management of Infected Non-union Tibia with Ilizarov External Fixator: Study on Tertiary Hospital in Bangladesh

Islam, Dr. Md. Sofikul; Hossain, Mohd Alamgir; Sobhan, Dr. Md. Abdus; Pramanik, Subrata; Rahman, Dr. Md. Mushidur; Rahman, Dr. Md. Munzur; Haque, Obaidul

doi:10.36347/sasjs.2022.v08i01.010

Cited by 3 publications

(4 citation statements)

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“…Individual techniques need to be tailored to the clinical case and the resource available to the treating team. Examples of low-cost Ilizarov techniques demonstrate that these treatment modalities are feasible in low resource settings ( 54 , 55 ). It is also possible to perform some microvascular reconstructions ( 56 ) but this is rare.…”

Section: Resultsmentioning

confidence: 99%

Management of fracture-related infection in low resource settings: how applicable are the current consensus guidelines?

Tissingh

Marais

Loro³

et al. 2022

EFORT Open Reviews

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The global burden of fracture-related infection (FRI) is likely to be found in countries with limited healthcare resources and strategies are needed to ensure the best available practice is context appropriate. This study has two main aims: (i) to assess the applicability of recently published expert guidance from the FRI consensus groups on the diagnosis and management of FRI to low- and middle-income countries (LMICs); (ii) to summarise the available evidence on FRI, with consideration for strategies applicable to low resource settings. Data related to the International Consensus Meeting Orthopaedic Trauma Work Group and the International Fracture Related Infection Consensus Group FRI guidelines were collected including panel membership, country of origin, language of publication, open access status and impact factor of the journal of publication. The recommendations and guidelines were then summarised with specific consideration for relevance and applicability to LMICs. Barriers to implementation were explored within a group of LMIC residents and experienced workers. The authorship, evidence base and reach of the FRI consensus guidelines lack representation from low resource settings. The majority of authors (78.5–100%) are based in high-income countries and there are no low-income country collaborators listed in any of the papers. All papers are in English. The FRI consensus guidelines give a clear set of principles for the optimum management of FRI. Many of these – including the approach to diagnosis, multidisciplinary team working and some elements of surgical management – are achievable in low resource settings. Current evidence suggests that it is important that a core set of principles is prioritised but robust evidence for this is lacking. There are major organisational and infrastructure obstacles in LMICs that will make any standardisation of FRI diagnosis or management challenging. The detail of how FRI consensus principles should be applied in low resource settings requires further work. The important work presented in the current FRI consensus guidelines is relevant to low resource settings. However, leadership, collaboration, creativity and innovation will be needed to implement these strategies for communities who need it the most.

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Section: Resultsmentioning

confidence: 99%

Management of fracture-related infection in low resource settings: how applicable are the current consensus guidelines?

Tissingh

Marais

Loro³

et al. 2022

EFORT Open Reviews

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“…Moreover, it will be required to decrease the number of people needed to demonstrate a change. 17,19,20 This study has some limitations. The sample is smaller and it is a single-centred study.…”

Section: Discussionmentioning

confidence: 96%

“…However, external fixator outcomes are also still excellent. [18][19][20] Further randomised studies must identify the most effective method for internal stabilizing fracture.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of open reduction and internal fixation with closed reduction and external fixation in distal radial fracture

Belbase¹,

Limbu²,

Basnet

et al. 2022

Int J Res Orthop

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Background: Radial fracture frequently occurs in osteoporotic disorders, or in low-energy injuries. It is most frequent fracture of the upper extremity. Open reduction or closed reduction is done but there is debate between the two about its efficacies. Aims and objectives were to find out the efficacy and safety of open reduction and internal fixation (ORIF) with that of closed reduction and external fixation (CREF) among patients with distal radial fracture of all ages.Methods: This prospective study was conducted with patients of distal radial fracture. They underwent interventions, namely, ORIF (Open reduction group) or CREF (Closed reduction group). DASH score was measured before the intervention and during several follow ups at 4th week to 15th week. DASH score was statistically analyzed between the two groups. Additionally, the complications of the patients in each group were evaluated and sick leaves of the patients was recorded to assess their quality of life.Results: The study has found that the number of days taking patients took sick leave from field work is significantly more in "closed reduction" group as compared to "open reduction" group (p<0.05). The number of days patients took sick leave is significantly higher in “closed reduction” group as compared to “open reduction” group (p<0.05).Conclusions: The study has concluded that the disability of the patients who received ORIF decreased significantly as compared to those who received external fixation and the patients who received open reduction significantly improved from the fracture.

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“…Traditional treatment options, including surgical debridement, internal fixation, and bone grafting, may not always provide satisfactory results, making it imperative to explore alternative therapeutic measures. 3 The Ilizarov external fixation method, developed by Dr. Gavriil Ilizarov in the mid-20th century, represents a unique and versatile approach to addressing these complex fractures. 4 It involves the use of a circular external fixator device that enables multiplanar correction of deformities, controlled distraction osteogenesis, and stabilization of the fracture site.…”

Section: Introductionmentioning

confidence: 99%

An evaluation of effectiveness of Ilizarov external fixation in treating infected non-union tibial fractures: a prospective observational study

Kumar,

Shankar

et al. 2024

Int J Res Med Sci

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Background: Infected non-union tibial fractures pose significant challenges in orthopedic care. Ilizarov external fixation has emerged as a promising treatment option for such complex fractures. The purpose of this research is to evaluate the efficacy and safety of Ilizarov fixation in non-union, infected tibial fractures. Methods: A prospective observational study was conducted on 30 patients at Indira Gandhi Institute of Medical Sciences. Inclusion criteria involved patients aged 20-65 with clinical and radiological signs of infection and non-union of the tibia. Data on patient demographics, injury details, treatment history, and outcomes were collected. Ilizarov fixation was performed, and patients were followed up. Results: The study cohort, primarily males (80%), with mean age of 35.75 years, displayed a high incidence of type III compound injuries (63.33%). Monofocal and bifocal osteosynthesis effectively reduced limb shortening, with an overall average residual shortening of 1.8 cm. Bony outcomes were favorable, with 16 cases achieving excellence. Functional outcomes were also promising. Complications included stiffness, infections, and deformities. Conclusions: Ilizarov external fixation demonstrates potential in managing infected non-union tibial fractures, offering favorable bony and functional outcomes. However, post-operative complications require vigilant management. Further research is needed to validate and optimize this approach.

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Management of Infected Non-union Tibia with Ilizarov External Fixator: Study on Tertiary Hospital in Bangladesh

Cited by 3 publications

References 0 publications

Management of fracture-related infection in low resource settings: how applicable are the current consensus guidelines?

Management of fracture-related infection in low resource settings: how applicable are the current consensus guidelines?

Evaluation of open reduction and internal fixation with closed reduction and external fixation in distal radial fracture

An evaluation of effectiveness of Ilizarov external fixation in treating infected non-union tibial fractures: a prospective observational study

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