Correction of Post-Infective Deformities of The Tibia Using the Ilizarov Circular External Fixation

Abstract

Background: Post-infective tibia deformities present significant challenges to orthopedic surgeons in resource-limited settings across sub-Saharan Africa. These conditions impose substantial economic, functional, and psychosocial burdens on patients and their families. The Ilizarov circular external fixator is recognized as a valuable tool in managing complex post-infective deformities, especially in pediatric patients within resource-limited settings. Objective: To highlight the effectiveness of the Ilizarov circular external fixator in managing complex post-infective tibial deformities in pediatric patients in a resource-limited setting. Methods: This case series highlights three pediatric patients with severe post-infective tibial deformities and significant limb length discrepancies, managed with Ilizarov external fixator at University College Hospital, Ibadan, Nigeria. Case 1: A 5-year-old female with 20 cm leg shortening and deformities post-surgery for tibia osteomyelitis at 6 months old. Case 2: A 5-year-old male with 6 cm leg shortening and deformity post-osteomyelitis. Case 3: A 9-year-old male with 16 cm leg shortening and deformity post-infection at 5 months old. Results: Treatment involved multi-staged surgical procedures using Ilizarov circular external fixation. Procedures included soft tissue release, gradual distraction, deformity correction, fibular centralization, tibio-fibular synostosis, and bone lengthening. All patients achieved substantial correction with residual limb length discrepancies of 2-3 cm and minor deformities planned for future correction. Conclusion: The Ilizarov circular external fixator proves to be a versatile and effective tool for managing complex post-infective tibial deformities in pediatric patients, even in resource-limited settings. This technique allows for simultaneous correction of multiple deformities and limb lengthening with acceptable functional outcomes.