Retrospective study of open tibial diaphyseal fractures type IIIA and IIIB by Ilizarov method

Abstract

Aim and Objective: Lower lumbar burst fractures are rare entity with most of the literature restricted to small case series. There is no clear cut consensus on the guidelines for management. Here we present functional results of different modalities of treatment of this rare type of spine injury. Material and Methods: The study was conducted at two tertiary care centres over a period of 9 years. Patients with lower lumbar burst fractures were evaluated for associated injuries, modality of treatment, Pain score (VAS) and neurological status (Frankel Grade) at the time of injury and at final follow up were recorded. The final functional outcome was evaluated using Smiley-Webster functional score. Results: A total of 34 patients with an average age of 37.3 years (24 males; 10 females) and a mean final follow up of 27.9 months were enrolled. 21 patients had L3, 8 had L4 and 5 had L5 burst fractures. 10 patients were managed conservatively by brace and 24 underwent surgical intervention. The pain score (VAS) improved from a mean of 8.5 at the time of injury to a mean of 1.6 at final follow up. Patients with neurological injury had on average improvement of one Frankel grade. 88% patients had excellent to good final functional outcome. Conclusion: Lower lumbar burst fractures are high velocity injuries with other non-spinal injuries being associated. Most of the patients have good functional outcome with both conservative as well as surgical intervention. Patients with complete cauda equina have poor outcome with respect to neurological recovery.