Evaluation of clinical efficacy and safety of the Ilizarov apparatus for external fixation (literature review)

Abstract

Purpose A retrospective analysis of clinical efficacy and safety of using the external fixation apparatus of G.A. Ilizarov's design. Materials and methods Analysis and evaluation of clinical data was performed using 107 literary sources. 4.200 clinical cases were studied to evaluate effectiveness, and 6.274 cases to assess safety. Results The analysis revealed a high clinical efficacy of using the Ilizarov apparatus for external fixation (various assemblies) in solving a wide range of practical problems in the field of traumatology and orthopedics. According to the results of the study, its high clinical treatment effectiveness was confirmed both on the use of the method in general (about 95 % of positive outcomes), and in specific nosological groups of patients (not lower than 90 % of positive outcomes). After having assessed the available data on the safety in the application of the Ilizarov apparatus for external fixation (various assemblies), we can conclude that the rates of adverse events, recorded in the literature analyzed, can be considered acceptable. Among all those events, the events classified as adverse effects of the product amounted to 17.03 % (5 ÷ 95 % CI: 16.11 ÷ 17.97 %).

Interest of circular external fixator in orthopaedic in low-income country

“…These pathologies can be classified into 4 groups: closed reduction and fixation of bone in fractures and nonunions; operative and bloodless limb lengthening; correction of deformities and management of lone bone defects without bone graft; compression arthrodesis of joints. The effectiveness of ICEF is similar to other fixation methods [11] . On the other hand, there is a significant difference in favor of ICEF when taking account the economic factor.…”

“…The positive outcomes rate in our study (95.6%) is similar to that reported in the literature. Indeed Soldotov et al [11] , in a review of the literature report a 95% of positive outcomes about 4,200 cases of all the pathologies treated and greater than 90% in each of the groups of pathologies. These pathologies can be classified into 4 groups: closed reduction and fixation of bone in fractures and nonunions; operative and bloodless limb lengthening; correction of deformities and management of lone bone defects without bone graft; compression arthrodesis of joints.…”

“…These procedures were really more expensive in out setting when the fixation was achieved done by others implant. The rate of failure outcome in the use of ICEF can be estimated at 4 to 5% according to the publications [11] . In our study, the first bad outcome was related to the economic factor because the patient could no longer pay for the various procedures required.…”

“…Two to four complications can be observed in the same patient [20] . Pin infections are the most frequent ranging from 17.03 to 100% of the cases treated [11], [20] . In our study this pin track infection healed with local dressing.…”