A comparison of functional outcome of open reduction internal fixation versus ilizarov external fixation in complex proximal tibial fractures: randomized controlled trial | [Journal of Islamabad Medical & Dental College • 2023]

Author(s):

1. Muhammad Farhan Farhat: Department of Orthopaedic Surgery, Pakistan Institute of Medical Sciences (PIMS),Islamabad,Pakistan

2. Zeeshan Khan Nazim: Department of Orthopaedics, Trauma and Spine Surgery, Hayatabad Medical Complex,Peshawar,Pakistan

3. Mohammad Osama: Department of Orthopaedic Surgery, Pakistan Institute of Medical Sciences (PIMS),Islamabad,Pakistan

4. Hassaan Ahmad: Department of Orthopaedic Surgery, Pakistan Institute of Medical Sciences (PIMS),Islamabad,Pakistan

5. Bilal Razzaq: Department of Orthopaedic Surgery, Pakistan Institute of Medical Sciences (PIMS),Islamabad,Pakistan

6. Muhammad Khan: Department of Orthopaedic Surgery, Pakistan Institute of Medical Sciences (PIMS),Islamabad,Pakistan

Abstract:

Objective: This study aimed to compare the functional outcome of Open reduction internal fixation and Ilizarov external fixation in the treatment of complicated proximal tibial fractures. Methadology: This study included 104 patients with Schatzker's grade IV-VI fractures who presented to the orthopedic department at PIMS, Islamabad. Using the lottery approach, the patients were split into two treatment groups at random. Group B uses the Ilizarov External Fixation procedure, while Group A uses the Open Reduction and Internal Fixation (ORIF) technique. Every three weeks, post-operative follow-ups were conducted. Up until the fracture healed, post-operative radiographs were taken every three weeks. Every patient had a 24-week clinical follow-up. Using SPSS v25.0, all of the data were input and processed. The surgery time, VAS score, and length of hospital stay were compared between the two groups using an independent sample t-test. The functional outcome at six months was compared between the two groups using the Chi-square test. Results: There were 31 (59.6%) men and 21 (40.4%) women in group A, and 36 (69.2%) men and 16 (30.8%) women in group B. In group A, the mean age was 44.87±14.15 years, while in group B, it was 44.25±15.68 years. In terms of functional outcome, 22 (42.3%) of the ORIF technique group had excellent outcomes, while 10 (19.2%), 16 (30.8%), and 4 (7.7%) had good, fair, and poor outcomes, respectively. In contrast, 35 (67.3%) of the Ilizarov technique group had excellent outcomes, while 10 (19.2%), 5 (9.6%), and 2 (3.8%) had good, fair, and poor outcomes, respectively. These results have a statistically significant p-value of 0.024. Conclusion: Compared to open reduction and internal fixation, Ilizarov external fixation is a more reliable method for fixing complicated proximal tibial fractures. For patients with complicated proximal tibial fractures, the Ilizarov external fixation approach yields superior functional outcomes than the open reduction internal fixation technique.

Page(s): 262-269

DOI: 10.35787/jimdc.v12i4.1050

Published: Journal: Journal of Islamabad Medical & Dental College, Volume: 12, Issue: 4, Year: 2023

Keywords:

Open reduction , internal fixation , Ilizarov external fixation , Proximal Tibia Fracture

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