Treatment of open fractures of the humerus using the g. a. ilizarov method

Background. Open fractures of the humerus are associated with soft-tissue damage, contamination, and a high risk of infection, non-union, and radial nerve injury, which limits the use of internal fixation in the acute period. The transosseous osteosynthesis method of G. A. Ilizarov allows stable fixation away from the zone of injury while leaving the wound accessible for treatment. Objective. To evaluate the clinical and functional outcomes of treating open humeral fractures with the Ilizarov circular external fixator. Materials and methods. A retrospective study included 46 patients (32 men, 14 women; mean age 38.6 ± 11.2 years) with open diaphyseal and metadiaphyseal fractures of the humerus (Gustilo–Anderson type I – 12, type II – 21, type IIIA – 10, type IIIB – 3) treated with primary surgical debridement and Ilizarov apparatus fixation. Time to union, complications, and functional outcome (DASH score, Constant–Murley score) were assessed at a minimum follow-up of 12 months. Results. Bone union was achieved in 44 of 46 patients (95.7%) with a mean fixation period of 14.2 ± 3.1 weeks. Superficial pin-site infection occurred in 9 patients (19.6%) and resolved with local care and oral antibiotics; deep infection was observed in 1 case (2.2%). Two patients developed delayed union requiring compression and bone grafting. The mean DASH score at final follow-up was 14.8 ± 7.9, and the mean Constant–Murley score was 84.3 ± 8.6. Excellent and good results were obtained in 89.1% of patients. Conclusion. The Ilizarov method is an effective and safe option for open humeral fractures, providing stable fixation, wound access, early mobilisation of adjacent joints, and a high rate of union with a low rate of deep infection.