Complications of Ilizarov Fixator in 105 Cases

Objective: The objective of this descriptive study was to assess the complications of locally made Ilizarov fixator. Study Design: Descriptive study. Place and Duration of Study: This study was conducted in Combined Military Hospital Quetta and Combined Military Hospital Rawalpindi over a period of 3 years from January 2007 till January 2010. Patients and Methods: One hundred five patients requiring Ilizarov fixator fixation for various indications were studied. We included all the patients who required Ilizarov fixation as a definitive means of treatment. Locally made Ilizarov fixator was used and Combined Military Hospital, Quetta Schanz screws were inserted without pre drilling. Records were kept in microsoft access database. Results: Male population dominated our sample by 95 (90.5%) with mean age of 32.16 years. Road traffic accident was most common aetiology affecting tibia in 77 (73.33%) cases. Average fixator time was 17.9 weeks, minimum 7 and maximum 48. We achieved satisfactory union in 102 (97.14%) patients with outcome graded as excellent in 69 patients (65.71%), good in 27 (25.71), fair in 6 (5.71%) and poor in 3 (2.85%) as per ASAMI criteria. Total complications were 78 (74.38%), infection in 33 (31.42%) cases, of which 17 (16.2%) were minor pin tract infections and 16 (15.3%) were major infections which require curettage. We had joint stiffness in 16 (15.3 %) patients. We had limb shortening of more than 2.5 cm in 5 (4.76%) patients and valgus or varus deformity of more than 7 degree deformity in 19 (18.09%). 1 (0.95%) patient had progressive dislocation of the knee joint, while Schanz screw breakage was observed in 1(0.95%) patient. Conclusion: Complications encountered can be reduced by observing Ilizarov principles. Pin tracts must be cleaned as per standard protocols, joint stiffness can be minimized by vigorous range of motion exercises and weight bearing. Neurovascular injuries are avoided by respecting their planes. Although complications are common, still this is an effective tool for treating complex skeletal disorders which at time require amputations.