.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.jpg)
Cost Effective Management of Open fractures shaft of femur in a Tertiary Care Hospital using Ilizarov fixator.
Keywords:
ASAMI score, Fracture, Femur, Ilizarov, UnionAbstract
Objective: To determine the functional and radiological outcomes of Ilizarov fixator in managing open fractures shaft of femur.
Methods: This descriptive study was conducted in Orthopaedic department Aga khan University hospital Karachi from 23rd January 20015 to 25th December 2020.All adults patients of both gender and age with open fracture femur fulfilling the inclusion criteria were operated with Ilizarov fixator. Functional and radiological outcomes were determined by using the Association for the Study and Application of Methods of Ilizarov (ASAMI) scoring system. The bone results and functional results were graded as excellent, good, fair and poor as per ASAMI scoring system.
Results: We operated 32 patients of open fractures femur with Ilizarov fixator. The mean age was 41±7 years. Male patients were 31(96.87%) and female 1(3.12%). Right sided femur shaft fracture was present in 17(53.12% ) and left sided in 15(46.87%). The aetiology of fractures was road traffic in 24( 75%) and gunshot in 8( 25%) patients. Gustilo Anderson type IIIA fractures were present in 22(68.75%) and type IIIB in 10(31.25%) patients. Post operative bone results using ASAMI score were excellent in 16(50%), good in 15(46.87%) and fair in 1(3.12% ) patient. Function result using ASAMI score were excellent in 18(56.25%),good in 13(40.62%) and fair in 1(3.12%) patient. The average cost of treatment was 350,000 rupees.
Conclusion: Illizarov fixator is a cost effective option for managing acute open femur fractures. Excellent and good functional and radiological results were achieved in majority of our patients.
References
Lyengar R, Cherukuri N, Patnala C..Reconstruction of Traumatic, Open Supracondylar Femoral Fractures by Autologous Fibular Strut Grafting and Cortico-Cancellous Bone Grafting-A Single-Centre, Observational Study. J Orthop Trauma 2018;32(2):75-81.
Abuomi IE, Sala F, Said MM, Elshal EA. Management of Femoral Bone Defect after Gunshot Injury using Circular External Fixator. J Pak Orthop Assoc 2018; 30(01):29-8.
Sen C,Balci HI,Celiktas M,Ozkan C,Gulsen M. Definitive Surgery for Open Fractures of the Long Bones with External Fixat?on. Basic Techniques for Extremity Reconstruction 2018;107-127.
Ilizarov GA, Lediaev VI, Shitin VP, The course of compact bone reparative regeneration in distraction osteosynthesis under different conditions of bone fragment fixation (experimental study). Eksp Khir Anesteziol1969;14(6):3-12.
Ilizarov GA. The tension-stress effect on the genesis and growth of tissues: Part I. The influence of stability of fixation and sort tissue preservation. Clin Orthop 1989;238:249-281.
Ilizarov GA. The tension-stress effect on the genesis and growth of tissues: Part II. The influence of the rate and frequency of distraction. Clin Orthop. 1989;239:263-285.
Vauhkonen M, Peltonen J, Karaharju E, Aalto K, Alitalo I. Collagen synthesis and mineralization in the early phase of distraction bone healing. Bone Miner 1990;10:171-181.
Gasser B, Boman B, Wyder D. Stiffness characteristics of the circular Ilizarov device as opposed to conventional external fixators. J Biomech Eng 1990;112:15-21.
De Bastiani G, Aldegheri R, Renzi Brivio L .The treatment of fractures with a dynamic axial fixator. J Bone Joint Surg Br 1984; 66:538-545.
Paley D, Catagni MA, Argnani F, Villa A, Benedetti GB, Cattaneo R. Ilizarov treatment of tibial non-unions with bone loss. Clin Orthop Relat Res. 1989;241:146-165.
Inam M, Saeed M, Sanaullah, Khan M,Durrani A,Arif M.Ilizarov External Fixator in The Management of Fractures of Femur.J Pak Orthop Assoc 2015;27(1):14-20.
Atesalp AS, Yildiz C, Basbozkurt M, Gur E. Treatment of Type IlIa Open Fractures with Ilizarov Fixation and Delayed Primary Closure in High-Velocity Gunshot Wounds. Military Medicine 2002;167:56-62.
Hahn SB,Park HJ, Park, Kim SH. Treatment of Comminuted Fractures of Femur & Tibia with Ilizarov Apparatus. J Korean Soc Fract. 2000;13(1):20-29.
Pavolini B, Maritato M, Turelli L, D'Arienzo M. The Ilizarov fixator in trauma: a 10-year experience. J Orthop Sci 2000;5:108-113.
Giovanni L, Rajesh R, Karan S. Circular external fixation as definitive treatment for open or comminuted femoral fractures: Radiologic and functional outcomes. J Clin Orthop Trauma 2019;10(1):115-122.
