Comparative study of the results of compound tibial shaft fractures treated byIlizarov ring fixators and limb reconstruction system fixators

Purpose: Ilizarov ring fixator and limb reconstruction system (LRS) fixators have been used in themanagement of complex tibial fractures with severe soft tissue injuries, compound tibial fractures, and infected tibial nonunion for which conventional internal fixation cannot be contemplated. Fracture union and distraction osteogenesis can be done simultaneously with these external fixators, allowing early weight bearing. Several previous studies have shown almost equal results of rail and ring fixators for the compound tibial shaft fractures. Thus we performed a prospective study to evaluate the union rate, functional outcome and amount of limb lengthening after the treatment of compound tibial shaft fractures with or without infected nonunion by ring or LRS fixators.Methods: This prospective study was done at Sarojini Naidu Medical College and Hospital, Agra, Indiaand included 32 patients of compound tibial shaft fractures with or without infected nonunion. Therewere 26 males and 6 females and the average age was 40 years. Patients were randomly divided into twogroups (n=16 for each): one underwent Ilizarov fixation and the other received LRS fixation. Cases were followed up for 3e24 months, 6 months on average from September 2012 to October 2014. Functionaland radiological outcomes were assessed using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria for both rail and ring fixators.Results: Union was achieved in all cases. Radiological outcome was found excellent in 68.75%, good in18.75% and fair in 12.50% of cases treated by rail fixators whereas it was excellent in 56.25%, good in 18.75%, fair in 12.50% and poor in 12.50% of cases treated by ring fixators. Functional result was satisfactory in 75.00% of cases treated by rail fixator and 68.75% of cases treated by ring fixators whereas the corresponding rate of unsatisfactory was 25.00% vs. 31.25%.Conclusion: In our short-term assessment, LRS fixators show a better result than Ilizarov fixators in terms of fracture union and functional outcome with soft tissue care and limb length.