Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026
Clinical and Functional Outcomes of Open Tibia-Fibula Fractures Managed with Ilizarove External Fixation: A 20 Case Study at CBMCHB Orthopedics Department
Chowdhury MR,1 Haque MA,2 Hasan S,3 *Uthsha TR4
Abstract
Background: The management of open tibia-fibula fractures, particularly those of higher Gustilo-Anderson grades, remains a significant challenge due to high rates of complications like infection and non-union. The Ilizarov external fixator (IEF) offers a versatile, minimally invasive technique allowing for early weight-bearing and excellent soft-tissue access. This study retrospectively evaluated the clinical and functional outcomes of open tibia-fibula fractures treated with IEF at our institution.
Methods: We retrospectively reviewed 20 consecutive patients with open tibia-fibula fractures treated definitively with the IEF at CBMCHB between [January 2023] and [January 2025]. The mean follow-up period was 24 months. Outcomes were assessed using the Association for the Study and Application of the Methods of Ilizarov (ASAMI) criteria for bone and functional results. Complications, time to union, and duration of external fixation were recorded.
Results: The mean time to radiologic union was 4.5 more or less 1.2 months (range, 3–7 months). According to the ASAMI criteria for bone results, 16 (80 %) cases achieved Excellent or Good outcomes. Functional results showed 15 (75%) patients had Excellent or Good outcomes. Pin-tract infection was the most common complication, observed in 4 (20%) cases, all of which were managed successfully with oral antibiotics and local wound care. No cases of deep infection or unacceptable malunion were recorded.
Conclusion: The use of the Ilizarov external fixator as a primary and definitive treatment for open tibia-fibula fractures, even in higher-grade injuries, yielded high rates of bone union and satisfactory functional outcomes. The ability to manage soft tissues and permit early weight-bearing makes the Ilizarov technique a valuable modality in this challenging patient population.
[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):54-59]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.8
Keywords: Open fracture, Tibia, Fibula, Ilizarov, External Fixation, ASAMI, Functional Outcome
- Dr. Mamunur Rashid Chowdhury, Associate Professor, Department of Orthopedics, CBMCHB. mamunakua@gmail.com
- Dr. Md. Anwarul Haque, Professor, Department of Orthopedics, CBMCHB
- Dr. Sabbir Hasan, Registrar, Department of Orthopedics, CBMCHB
- *Dr. Tanmoy Ray Uthsha, Medical Officer, Department of Orthopedics, CBMCHB. druthsha@gmail.com
*For correspondence