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Background <p>In an era of healthcare cost containment, this study introduces a novel closed reduction technique using the Ilizarov circular external fixator for comminuted tibial fractures (AO/OTA 42C2-3), minimizing operative interventions and costs compared to internal fixation.</p> Methods <p>We conducted a retrospective analysis of 20 consecutive patients with high-energy tibial fractures managed with a single Ilizarov frame. Postoperative deformities (angulation, translation, rotation) were corrected painlessly in outpatient settings without anaesthesia.</p> Results <p>Eighteen patients (90%) achieved union with one frame application; median time to union (injury to frame removal) was 150 days. Two patients had delayed union resolving conservatively. All injuries resulted from road traffic collisions (42C2/42C3). No amputations or compartment syndromes occurred. Pin-tract infections in two patients (10%) required wire exchange. No malunions necessitated reoperation, though two patients (10%) suffered refractures requiring repeat Ilizarov treatment. Per modified ASAMI scores, most achieved excellent/good functional outcomes.</p> Conclusion <p>This technique delivers reliable union with outpatient, anaesthesia-free deformity correction, avoiding internal fixation's risks (deep infection, compartment syndrome, malrotation) while optimizing cost-effectiveness. Multicenter validation is warranted.</p>

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Outpatient deformity correction: novel closed reduction technique transforms tibial trauma care

  • 期刊论文

  • 发表日期：

    2026年3月9日

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  • Gamal Hosny,
  • NourEldin Elmesalamy,
  • Salma Awadallah,
  • Ahmed Abdelnaser

摘要

Background

In an era of healthcare cost containment, this study introduces a novel closed reduction technique using the Ilizarov circular external fixator for comminuted tibial fractures (AO/OTA 42C2-3), minimizing operative interventions and costs compared to internal fixation.

Methods

We conducted a retrospective analysis of 20 consecutive patients with high-energy tibial fractures managed with a single Ilizarov frame. Postoperative deformities (angulation, translation, rotation) were corrected painlessly in outpatient settings without anaesthesia.

Results

Eighteen patients (90%) achieved union with one frame application; median time to union (injury to frame removal) was 150 days. Two patients had delayed union resolving conservatively. All injuries resulted from road traffic collisions (42C2/42C3). No amputations or compartment syndromes occurred. Pin-tract infections in two patients (10%) required wire exchange. No malunions necessitated reoperation, though two patients (10%) suffered refractures requiring repeat Ilizarov treatment. Per modified ASAMI scores, most achieved excellent/good functional outcomes.

Conclusion

This technique delivers reliable union with outpatient, anaesthesia-free deformity correction, avoiding internal fixation's risks (deep infection, compartment syndrome, malrotation) while optimizing cost-effectiveness. Multicenter validation is warranted.