Introduction
Open supracondylar-intercondylar fractures of the femur constitute one of the challenges
in orthopaedic practice. The problem is exaggerated by the associated contamination, soft
tissue damage, comminution, and articular damage. The aim of this study was to evaluate
the outcomes of using Ilizarov external fixator to treat open intraarticular distal femur
fractures.
Patients and Methods
This prospective study included 19 patients with 13 males and 6 females. The mean age
was 37.26 (Range 21-51) years. Most cases (16 fractures) were due to road traffic accidents,
while three were secondary to gun-shot trauma. The average duration from trauma
to surgery was (Range 1-10) days. All fractures were AO-OTA type 33C. Fifteen cases
were open grade III-A, 3 cases were grade III-B, and one case was grade III-C. Seven
patients (36.8%) had associated injuries. Patients were treated by Ilizarov external fixator
with cannulated lag screw fixation of the condylar fragments. Additional proximal tibial
fixation was needed in 9 cases. Bone grafting was required in 5 cases. The frame was
removed after an average of 6.31 months.
Results
The follow-up duration averaged 31.32 months. At the last follow-up, union was achieved
in all cases. ROM averaged 94.47° (Range 50°-125°). Mild valgus angulation (5-7°) occurred
in four cases. Three cases had shortening of about 1.5 cm. Pin track infection occurred
in 14 cases. Two cases suffered deep infection. According to ASAMI criteria, 10
patients had excellent bone results, 7 cases had good results, and the remaining two had
fair results. Functional results were excellent in 8 patients, good in 6 cases, and fair in 5
cases.
Conclusions
Ilizarov fixator provided a viable treatment alternative for open supracondylarintercondylar
femur fractures allowing early ambulation. Despite having reduced knee
ROM in several patients, adequate limb alignment was obtained, and the patients were
pain free with stable knee allowing for daily activities. |
