Forty-two high-energy tibial fractures (18 closed and 24 open) in 41 patients were treated with Ilizarov apparatus between 1999 and 2004. Open wounds were debrided and tension free primary closure using interrupted nylon sutures was attempted wherever appropriate. In others, either split thickess skin grafting or local gastrocnemius flaps were used. Corticotomy and bone transport was instituted in patients with significant bone loss. Early weight bearing with range of motion exercises of ankle and knee joints were encouraged. Average fracture healing time was 5.3 months (range 3.5 ... 8.5 months). Complications included pin site inflammation / infection (40.4 %), muscle transfixation (2 cases), shortening (3 cases), ankle joint stiffness (2 cases) and wire fracture (1 case). Based on Johner and Wruh's Criteria, there were 34 excellent, 6 good, 2 fair, and no poor results. The Ilizarov device provided early and definitive fixation for high-energy tibial fractures with good results. Introduction Fractures of tibia are very common in patients with trauma (1). Their treatment, prognosis, and outcome are mainly determined by the mechanism of injury, degree of resulting comminution, soft tissue injury and displacement (2). Fractures produced by indirect trauma have a better prognosis than those produced by direct trauma (3,4). The risk of delayed union and nonunion in closed (1,4) and open treatment is increased with comminution (5). Open fractures have a higher infection rate than closed fractures (6) and the rate increases with the increasing severity of the soft tissue injury (7,8). Minimally displaced fractures allow more simple treatment than displaced fractures (1). Therefore high-energy injuries have added to the number and complexity of fractures of long bones, especially those of tibia and so have the treatment modalities addressing them. We evaluated the use of Ilizarov device as the initial and definitive mode of fracture stabilization of these fractures.
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