In the cost-conscious era: Ilizarov circular frame or uniplanar external fixator for management of complex open tibia shaft fracture, retrospective cohort study from a level-1 trauma center.

Objective: External fixation is the most commonly used method for temporary management of open fractures of the Tibial shaft followed by internal fixation. This can also be used as a definitive method of fixation. Ilizarov is more superior and can be the primary and definite option where expertise is available. This study was conducted todetermine the outcome of open tibia shaft fracture treated with either Ilizarov or AO External Fixator. Methods: Anon-commercial retrospective cohort was conducted at Aga Khan University Hospital Karachi on patients operated for isolated open tibia fractures Gustillo type III (A, B, C) stabilized with external fixation either circular or uniplanar external fixator. These two groups were compared in terms of fracture pattern, healing and complications. For fracture healing, Radiographic union score (RUST) for tibial fractures were used. Result: A total of 93 patients were included in the study. Mean age 36.7 +/- 17.3 years comprising 83 males and 10 females. Circular Fixator was used for 46 whereas 47 were treated with uni-planar fixator. Mean new injury severity score was 21 +/- 3.4 for circular fixator group and 26 +/- 7 in uniplanar fixator group. Mean time fur fracture healing was 6 +/- 1 months in circular fixator group and 9 months in Uniplanar Fixator group. Mean RUST score for circular fixator was 9.5 +/- 1.2. and of uniplanar it was 7.3 +/- 1.0. Conclusion: Circular fixator works as a single stage procedure with acceptable outcomes for Gustilo grade III open tibial shaft fractures as compared to uniplanar external fixator.