{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:14:20Z","timestamp":1787004860489,"version":"build-2736575974"},"reference-count":38,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Introduction Open and closed fractures of the tibial shaft or distal tibia can be challenging for surgeons to treat if the fractures are accompanied by aggravating conditions, such as various accompanying diseases, pronounced soft tissue injuries, osteomyelitis, and\/or noncompliance. The aim of this retrospective study was to present our approach and results with the Ilizarov fixator as a treatment option for such individually complex cases. Materials and Methods Between 2005 and 2018, 20 patients were treated with the Ilizarov fixator for fractures of the tibial shaft\/distal tibia. The indication for this was a 2nd- to 3rd-degree open fracture in 10 patients, a 1st-degree open fracture in one patient, and closed fractures in 9 patients. Aggravating conditions included soft tissue injuries, osteomyelitis, leg deformities, multiple traumas, smoking, alcohol\/drug abuse, and obesity (BMI &gt; 60). In addition to demographic data,\n      the time of fixator treatment, complications, and the endpoint of consolidation were evaluated retrospectively. Results The mean time of fixator treatment was 29 (range 15\u201365) weeks. Complete fracture consolidation was achieved in 13 patients (65%) with the Ilizarov fixator. The mean follow-up period after fixator removal was 36 (range 2\u2013186) months in 14 patients. Five patients with complete consolidation were lost to further follow-up. One patient was amputated. In six patients without union, internal osteosynthesis was carried out. Conclusion The use of the Ilizarov fixator is a treatment option for individual high-risk patients with complicating courses but should be seen as a salvage procedure due to the high complication rate and long treatment process.<\/jats:p>","DOI":"10.1055\/a-1910-3606","type":"journal-article","created":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T19:42:12Z","timestamp":1664307732000},"page":"166-178","source":"Crossref","is-referenced-by-count":6,"title":["The Use of the Ilizarov Fixator for the Treatment of Open and Closed Tibial Shaft and Distal Tibial Fractures in Patients with Complex Cases"],"prefix":"10.1055","volume":"162","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0161-0284","authenticated-orcid":false,"given":"Charlotte","family":"Cibura","sequence":"additional","affiliation":[{"name":"Chirurgische Klinik und Poliklinik, Berufsgenossenschaftliches Universit\u00e4tsklinikum Bergmannsheil, Bochum, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Ull","sequence":"additional","affiliation":[{"name":"Chirurgische Klinik und Poliklinik, Berufsgenossenschaftliches Universit\u00e4tsklinikum Bergmannsheil, Bochum, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Rosteius","sequence":"additional","affiliation":[{"name":"Chirurgische Klinik und Poliklinik, Berufsgenossenschaftliches Universit\u00e4tsklinikum Bergmannsheil, Bochum, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Lotzien","sequence":"additional","affiliation":[{"name":"Unfallchirurgie, Berufsgenossenschaftliches Universitatsklinikum Bergmannsheil, Bochum, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Periklis","family":"Godolias","sequence":"additional","affiliation":[{"name":"Chirurgische Klinik und Poliklinik, Berufsgenossenschaftliches Universit\u00e4tsklinikum Bergmannsheil, Bochum, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin","family":"Rausch","sequence":"additional","affiliation":[{"name":"Chirurgische Klinik und Poliklinik, Berufsgenossenschaftliches Universit\u00e4tsklinikum Bergmannsheil, Bochum, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Schildhauer","sequence":"additional","affiliation":[{"name":"Chirurgische Klinik und Poliklinik, Berufsgenossenschaftliches Universit\u00e4tsklinikum Bergmannsheil, Bochum, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Kruppa","sequence":"additional","affiliation":[{"name":"Chirurgische Klinik und Poliklinik, Berufsgenossenschaftliches Universit\u00e4tsklinikum Bergmannsheil, Bochum, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,9,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2179","DOI":"10.1007\/s11999-015-4224-y","article-title":"Which Surgical Treatment for Open Tibial Shaft Fractures Results in the Fewest Reoperations? 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Am"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1007\/s00068-017-0783-9","article-title":"Diagnostic strategies for posttraumatic osteomyelitis: a survey amongst Dutch medical specialists demonstrates the need for a consensus protocol","volume":"44","author":"GAM Govaert","year":"2018","journal-title":"Eur J Trauma Emerg Surg"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1302\/2046-3758.86.bjr-2018-0344.r1","article-title":"Tobacco and bone fractures: A review of the facts and issues that every orthopaedic surgeon should know","volume":"8","author":"J Hernigou","year":"2019","journal-title":"Bone Joint Res"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"R163","DOI":"10.1530\/joe-14-0039","article-title":"Anorexia nervosa and bone","volume":"221","author":"M Misra","year":"2014","journal-title":"J Endocrinol"}],"container-title":["Zeitschrift f\u00fcr Orthop\u00e4die und 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