Analysis of results of huge segmental bone loss of tibia treated with Ilizarov external fixator: our experience in Indian population

Background: Orthopaedic surgeons face challenges in treating complex tibial fractures with bone loss due to complications like infection, repeat surgeries, and patient psychological burden. The Ilizarov external fixator approach offers better clinical and radiological results, addressing these issues. The purpose of this study was to examine the outcome of tibial segmental loss treated with the Iliazrov external fixator. Methods: The study was done between January 2015 to December 2021. It’s a prospective as well as retro-prospective study. The age group of 18-65 years was considered. Patients were monitored monthly, up to nine months post-surgery, or until bone union. Functional and bone outcomes of the patients were evaluated using ASAMI criteria, knee society score, and St. Pierre ankle scoring system. Results: The study included 20 patients, all of them were male and had a mean age of 34.1±10.1. Bone union was achieved in all cases. After ilizarov application, the average bone defect was 82.6±42.9 mm. The final regeneration attained was 75.1±47.5 mm. The average limb length difference was 20.41±6.55 mm after achieving union. Out of 20 patients, 13 and 4 had good and fair ASAMI score, 1, 4, and 13 had fair, good, and excellent knee society score, and17 had fair St. Pierre score and 3 patients were lost to follow-up. Conclusions: Ilizarov technique is an excellent way for treating complicated tibial fractures. The difficulties, challenges, and complications associated with Ilizarov external fixation are negligible compared to the significant difficulties associated with open techniques

Delayed replantation of avulsed tooth with 4½ days extraoral time with 18 months follow up

Avulsion or exarticulation is one of the most severe injuries of the tooth, frequently encountered in young children and the maxillary anterior teeth. Immediate transplantation of the avulsed tooth is the suggested treatment that results in a favorable prognosis, although this may not be possible every time. Here, we present a case report of an 8-year-old girl who sustained an avulsion injury of the maxillary left central incisor with 4½ days extraoral time. Treatment guidelines for avulsed immature permanent teeth with prolonged extraoral dry time were followed. Portland cement was used for obturation of the root canal. The clinical and radiographic findings after 18 months revealed minimal inflammatory root resorption and ankylosis of the replanted tooth, whereas clinically, the tooth was asymptomatic and maintained the aesthetics of the child, suggesting the importance of replantation, although there was prolonged extraoral dry time