الفهرس 
Introduction.Only 14 pages are availabe for public view
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Abstract
The management of displaced distal tibial fractures is still controversial. The different internal fixation techniques are often burdened by relatively high complication rates.
Minimally invasive techniques with ring fixators have been introduced as an alternative allowing immediate reduction and stabilization, avoiding a staged protocol. The aim of this prospective study was to analyze the clinical and radiographic outcome the Ilizarov technique in patients with distal tibial fractures, with or without intra-articular involvement.
Twelve patients with distal tibial fractures treated with the Ilizarov technique, the mean follow up period was 12 months (ranged from 6 to 24 months).
Depending on the type of fracture, 3 or 4 rings were used. Unrestricted weight-bearing was allowed in all cases at 6 weeks. Pre- and post operatively conventional radiographs, post-operative pain assessment and complications were evaluated.
Clinical outcomes were evaluated according to the ankle-hindfoot score devised by the American Orthopaedic Foot and Ankle Society (AOFAS)
No patient developed compartment syndrome or deep venous thrombosis. Pin infections were frequent, but they were mostly superficial and were treated with antibiotics and local antiseptics.
2 cases of malunion occurred, one of them required ankle fusion, . Another patient had a severe residual deformity. One case experienced delayed union and was treated with dynamisation of ilizarov frame, otherwise all fractures united and the fixator was removed after a mean of 20 weeks (range 12–28). The clinical outcome according to AOFAS score was excellent in 6 patients, good in 3, fair in 2 and poor in 1.
Conclusion
The study shows that it is possible to achieve a satisfactory outcome, in distal tibial fractures, with the Ilizarov technique allowing early definitive treatment. The fractures were treated immediately after the injury, regardless of soft-tissue damage. This was done with a similar low complication rate in both the extra-articular and the intra-articular fractures. Patient compliance was good. The residual deformities were within the range in which the risk of developing post-traumatic osteoarthritis can be expected to be low.