Study Summary

78 children with open tibial fractures and extensive soft tissue defects were randomized to receive either Ilizarov external fixation with microsurgical anterolateral thigh flap reconstruction or conventional internal fixation with standard wound management. The outcomes of interest were soft tissue healing assessed using the Zygo-Scale, osteomyelitis incidence, joint ankylosis scores, renal function markers, flap-related complications, and need for revision surgery. Outcomes were assessed at 7, 30, 60, and 90 days, and at 12 months. Overall, the results of the study revealed significantly faster and more complete soft tissue healing, lower rates of osteomyelitis, and reduced joint ankylosis in the combined treatment group. These findings suggest that integrating Ilizarov fixation with free anterolateral thigh flap reconstruction improves clinical and functional outcomes in pediatric patients with complex open tibial fractures.