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Steel Frame As Good As Open Surgery For Bone Fractures, Swedish Study Finds

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A new study shows that an unorthodox method of treating bone fractures may offer advantages over the more traditional approach.

The Ilizarov method, which uses a steel frame, was developed by Professor Gavril A. Ilizarov in the Soviet Union in the 1950s and is routinely used in Eastern Europe to this day.

However, it has only occasionally been used in the West, mainly for complex procedures such as leg lengthening, according to a report by the Sahlgrenska Academy at the University of Gothenburg. One exception is the Orthopedic Clinic at Skaraborg Hospital in Skövde, Sweden, where more than 700 patients have been treated using the Ilizarov method since 2002.

The method involves drilling thin wires through the broken bone fragments and then affixing these wires to rings, which are held in place by external struts.

Dr. Telmo Ramos, who works in Skövde, has carried out a scientific evaluation of the Ilizarov method, investigating patients with lower leg fractures who were treated using this method and comparing the results with those from patients treated with traditional open surgery, in which the bone fragments are fixed with the aid of pins, plates and screws.

His findings – published in a thesis titled ‘On the Treatment of Tibial Fractures using the Ilizarov Fixator´ – show that the Ilizarov method gives results at least as good as an open surgical procedure. A further benefit is that patients are not exposed to the risks involved in open surgery, they can be discharged more rapidly and they can place load on the leg as soon as the fixator is in place.

“When planning surgery for certain complicated lower leg fractures, it is often necessary to wait until the swelling has decreased before operating. This is not necessary with the Ilizarov method, and thus the patients do not need to stay in hospital as long,” Dr. Ramos explained.

“Further, the fact that the patients can immediately start to place load on the leg is beneficial both for rehabilitation and the quality of life,” he added.

Results also show that, although the outer frame appears to be clumsy and heavy, patients accept the treatment very well and do not experience major difficulties in moving around.

Dr. Ramos wants to see the method introduced more widely into Swedish orthopedic care, supplementing the treatments that are already available.

Further studies will test the Ilizarov method for other types of fracture, including fractures of the wrist, heel bone, upper arm and pelvis.