Author(s): Dr. Neelanagowda VP Patil, Dr. Arun GR, Dr. Deepak MK and Dr Arun Mohan

Abstract: Background and Objectives: Fractures of the distal tibia, especially complex open fractures have been historically difficult to manage due to the poor soft tissue envelope around the bone and the precarious blood supply. In this study, we aim at devising an economical model of a hybrid external fixator for complex distal tibia fractures by using reused Ilizarov rings and A O rods after adequate methods of sterilization and study the functional outcome, time to union and complications associated with it.Objectives: To devise an economical model of hybrid external fixator for the management of complex distal tibia fractures and to study the Functional outcome, Time to union and associated complications.Methods: Total 16 patients with complex distal tibia [AO type 43(A1-A3, B1-B3, C1-C3)] fractures were treated in our institution with an economical model of hybrid external fixator using reused Ilizarov rings and A O rods after adequate methods of sterilization between June 2019 to December 2021. Patients were followed up every 6 weeks till 6 months and then at the end of 1 year. Patients were evaluated for functional and radiological outcome using the Ovadia and Beals scoring criteria. Time to union and Immediate and late complications were analyzed.Results: Total 16 patients were evaluated postoperatively for functional and radiological outcome using Ovadia and Beals criteria which showed 3 patients (18.75%) had well to excellent and 13(81.25%) patients had fair outcome. The average duration for fracture union was 33.25 weeks. 6(37.5%) patients had pin tract infection which was treated with adequate antibiotics and pin tract care. No deep infections were noted. There were 7(43.75%) cases of joint stiffness, 5(31.25%) cases of mal union and 2(12.5%) cases of delayed union. Reusing the non invasive components of the fixator helped us in reducing the overall operating cost of the surgery by 35-40%.Interpretation and Conclusion: In our study, we found that reusing the non invasive components of a hybrid external fixator is an economical treatment option for complex distal tibia fractures when combined with minimal internal fixation of fibula fracture, adequate antibiotic coverage, wound and pin tract care and aggressive physiotherapy.

DOI: https://doi.org/10.33545/orthor.2022.v6.i1a.344