Clinical Outcome of Ilizarov External Fixation in Gustilo-Anderson Type III Open Tibial Fractures

Open Access

Abstract

Background: Open tibial fractures, particularly Gustilo-Anderson type III lesions, present formidable challenges due to high infection and nonunion risks. The Ilizarov technique provides stable mechanical fixation while promoting osteogenesis, yet regional outcome data remain sparse. Objective: To assess the bone union rate and functional recovery following Ilizarov external fixation in these severe fractures. Methods & Materials: This prospective cohort study was performed at National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, from January 2023 to December 2025. A total of 47 purposively selected patients with type III open tibial fractures underwent Ilizarov frame application. Postoperative follow-up continued until union or for at least 12 months. Bone and functional outcomes were graded using the ASAMI scoring system. SPSS v23.0 was used for analysis. Results: Primary union occurred in 42 patients (89.4%), with a mean consolidation time of 4.8 months (range 3.2-7.5). ASAMI bone scores showed 31 excellent (66.0%) and 11 good (23.4%) outcomes. Functional outcomes were excellent in 28 (59.6%) and good in 13 (27.7%). Superficial pin-site infections developed in 9 cases (19.1%), and malunion in 5 (10.6%). Conclusion: The Ilizarov method demonstrates high efficacy for managing Gustilo-Anderson type III open tibial fractures, achieving robust bone healing and acceptable function with manageable complications in our cohort.