Staged complete dynamisation of the Ilizarov fixator: the Chertsey experience

Abstract

We present our results for a simple technique for staged dynamisation and removal of the Ilizarov fixator in fracture treatment. The study involved review of prospectively collected, consecutive, single surgeon case series data. All cases included were fractures treated by Ilizarov frame by the senior Consultant author between May 2005 and May 2007 in our trauma unit. Thirty-nine patients entered study, and 36 completed the follow-up period. When patients were able to weight-bear pain free with radiological evidence of healing, frames were dynamised, initially by loosening the rods across the fracture site, then by removing all rods across the fracture site and finally the frame removed under general anaesthetic. No bracing or casting was applied post-frame removal. The main outcome measure was mean frame time and development of late deformity or complication. Of 39 fractures, 36 underwent staged dynamisation. No patients required further casting, bracing or walking aids after frame removal. There were no incidences of re-fracture, non-union or late mal-union at 1-year follow-up. The method of staged dynamisation is a safe, simple and effective technique for confirming fracture union and timing of frame removal in a fracture clinic environment.