Treatment of type IIIa open fractures with Ilizarov fixation and delayed primary closure in high-velocity gunshot wounds

Mil Med. 2002 Jan;167(1):56-62.


A total of 142 patients with 163 Gustilo-Anderson type IIIa limb fractures resulting from high-velocity gunshot wounds were treated with primary delayed closure and Ilizarov fixation in our department between 1988 and 1998. Average follow-up was 72.4 months. The average union period in fractures without bone loss was 16.8 weeks. It took 2 months for each 1 cm of bone defect to heal in fractures with bone loss. All fractures healed with good anatomic alignment and functional outcomes. Complications included pin-track infection in 72 fractures (50.7%), post-traumatic osteomyelitis in 5 tibial fractures without bone loss (3.1%), delayed union in 25 fractures (15.3%), nonunion in 10 (4 with bone loss) fractures (6.1%), and refracture in 4 fractures (2.4%). Our results indicate that type IIIa limb fractures caused by high-velocity gunshot wounds can be treated with Ilizarov fixation and primary delayed closure with a low overall complication rate and a remarkably low infection rate.

MeSH terms

  • Adolescent
  • Adult
  • Arm Injuries / surgery*
  • Female
  • Fractures, Bone / surgery*
  • Humans
  • Ilizarov Technique*
  • Leg Injuries / surgery*
  • Male
  • Middle Aged
  • Wounds, Gunshot / complications
  • Wounds, Gunshot / surgery*