Ilizarov external fixation versus plate osteosynthesis in the management of extra-articular fractures of the distal tibia

Purpose The purpose of this study was to evaluate the outcome of Ilizarov external fixation (IE) versus dynamic compression plate (PO) in the management of extra-articular distal tibial fractures. Methods Between 2010 and 2011, extra-articular distal tibial fractures in 40 consecutive patients met the inclusion criteria. They were classified according to AO classification fracture type A (A1, A2, and A3). In a randomized method, two equal groups were managed using either IE or PO. PO was performed using open reduction and internal fixation (ORIF) and DCP through anterolateral approach. IE was done using Ilizarov frame. For the PO group, non-weight bearing ambulation was permitted on the second postoperative day but partial weight bearing was permitted according to the progression in union criteria clinically and radiologically. For the IE group, weight bearing started as tolerated from the first postoperative day. Physiotherapy and pin-site care was performed by the patient themselves. Results Modified Mazur ankle score was applied to IE (excellent 10, good 10) and in PO (excellent 2, good 8, poor 6). Data were statically analysed using (Mann-Whitney test). The rate of healing in the IE group (average 130) was higher than the PO (average 196.5); plus, there were no cases of delayed union or nonunion in the IE group (p value 0.003). Conclusion It was found that IE compared with PO provides provision of immediate weight bearing as tolerated following postoperative recovery, irrespective of radiological or clinical healing with no infection, deformity or non-union.