A one-wire method for anatomic reduction of tibial fractures with Ilizarov frame.

Abstract

Traditional external fixator techniques do not always correct minor residual malalignment. We asked whether using a one-wire method that corrects minor malalignment with an olive traction wire placed in the plane of the deformity allowed (1) uniform healing, (2) proper alignment, and (3) adequate reduction of fracture gaps. We retrospectively evaluated 72 patients in whom we used closed tibial fracture reduction using a circular external frame. We identified the plane of the residual deformity after alignment on a traction table using a C-arm. In this plane, the final correction was performed with traction through an olive wire. Satisfactory alignment (less than 3 degrees deviation from normal) was obtained in 68 of the 72 patients (94%), and satisfactory reduction (gaps less than 2 mm) attained in 51 (71%). In no case was the fracture site opened surgically. Four patients underwent additional alignment correction with conical washers outside the operating room but no other efforts were needed to obtain further reduction after the initial surgery. Fractures healed in an average of 20 weeks. We observed no major infections. The Ilizarov frame has been a valuable tool to achieve alignment and anatomic or near anatomic reduction of closed tibial fractures. Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.