Case 12: Open IIIB Tibia Fracture, Severely Contaminated, Treated with Ilizarov

Abstract

Open tibia fractures with gross contamination present several challenges to the treating surgeon. These include the need for soft tissue reconstruction, increased risk for both early and delayed infection, and significant bone loss, requiring reconstruction. Bone transport with the use of an Ilizarov ring external fixator can provide a treatment strategy for these complex injuries. The Ilizarov frame has the advantages of minimally invasive application around areas of soft tissue reconstruction, and it may be used in the setting of acute or chronic infection, when surface implants are contraindicated. Ilizarov treatment can allow early joint range of motion and weightbearing. The Ilizarov method can be used to promote both bony healing and manage any necessary deformity of the limb. The treatment process is prolonged and often requires further interventions, including frame revisions, partial fibulectomy, bone marrow aspirate injection, or local bone grafting. Therefore patients and their families need to understand the treatment duration and expected planned surgical interventions.