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COMPLEX TRAUMA AND RECONSTRUCTION IN THE UPPER LIMB USING ILIZAROV FIXATORS

Department Of Trauma And Orthopaedics, Northern General Hospital, Sheffield, UK

To review indications and outcomes of all Ilizarov arm fixators applied by the two limb reconstruction surgeons. All patients treated with an upper limb Ilizarov frame were identified. Casenotes were reviewed. Demographic data, indications and duration of frames collected. Forty-seven patients had application of an arm frame. Average age 43 (17–81). Tertiary referrals in 72%. Previous surgery in 79%. Mechanism of injury included: 37% RTA, 40% simple falls. Reasons for frame usually multifactorial. Half of fixators applied acutely (<6 weeks), 17 for non-unions. Two patients had neurological complications from frame surgery. One radial palsy possibly from humeral plate removal. One median palsy due to pressure from wire. Average frame time was 152 days (34–343). Over 80% achieved expected outcome -obtaining good function or fracture union. One patient had an above elbow amputation for persistent infection. Fourteen needed further frame surgery including 5 for frame removal, 3 adjustments and 2 corticotomies for lengthening. Most frames removed in clinic. The Ilizarov technique appears well tolerated and successful despite often infected or deformed tissues. Indications and intended function of arm frames very varied. This technique allows stabilisation (with/without bone loss), treatment of non-unions and lengthening/ bone transport. The Ilizarov technique is valuable for limb salvage/ reconstruction.

The abstracts were prepared by Cormac Kelly. Correspondence should be addressed to The Secretary, British Elbow and Shoulder Society, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE