ANATOMICAL RESTORATION OF THE MECHANICAL AXIS PROMOTES BONE HEALING WITHOUT CALLUS: LEARNING FROM ILIZAROV FRAME FIXATION

Introduction Our unit has extensive experience with the use of Ilizarov circular frames for acute fracture and nonunion surgery. We have observed and analysed fracture healing patterns which question the role of relative stability in fracture healing and we offer limb mechanical axis restoration as a more important determinant. Aim To assess for the presence of external callus, when only relative stability has been achieved but with anatomical restoration of the mechanical axis (ARMA). Methods We retrospectively reviewed diametaphyseal proximal and distal tibial fractures treated with Ilizarov frame fixation in our unit between 2009 and 2017. We also reviewed cases where the Ilizarov frame technique had been used for complex femoral and humeral non-unions. Radiographs in 4 views were reviewed to assess bone healing, the presence of external callus and correction of lower limb mechanical axis. Results 45 tibial plateau fractures, 42 distal tibial fractures and 20 humeral and 3 femoral non-unions were revie...