Closed Treatment of Metaphyseal Extraarticular Fractures of the Tibia by Ilizarov External Fixator

Closed metaphyseal extraarticular fractures of the tibia are relatively difficult to treat; due to the possible inability to use intramedullary nails or due to unfavorable skin condition making plate fixation hazardous. Therefore, the current study aimed at evaluating the Ilizarov circular fixator, applied via a closed technique, as an alternative for the management of such difficult fractures to preserve the vitality of soft tissues and allow for early function.This prospective study included 21 adult patients who presented with closed recent unilateral metaphyseal extraarticular fractures of the tibia treated in kasr el aini university hospitals. Three patients had segmental fractures involving both the proximal metaphysis and the diaphysis. Six patients had proximal metaphyseal fractures and twelve patients had distal metaphyseal fractures of the tibia. The majority of the fractures were caused by road traffic injuries. There were four cases with other associated fractures and injuries.The average follow-up was 18 months, ranging from twelve to thirty- six months. All fractures ended with healing but one case needed secondary grafting and ilizarov apparatus readjustment.Pin tract infection occurred in all cases and was treated effectively with local and general antibiotics. The average time from frame application till union was five months and ranged from 3.5 months to 8 months.It could be concluded that Ilizarov method is comparable to other treatment modalities and may be considered superior if these proximal or distal metaphyseal fractures are accompanied by unfavorable skin conditions.