Adaptation of Ilizarov ring fixator to the economic situation of developing countries.

Especially in countries with low per capita income, poor patients with open fractures and non-unions are unable to purchase modern, commercially produced surgical implants. To alleviate this situation, we initiated the production of a locally made ring fixator. The rings were cut from tubes cast from scrap aluminium. It was applied in 40 patients to test its utility for the typical indications for the Ilizarov technique. The fixator was tolerated well. All fractures united except in one case where there was refracture of the consolidate due to too early removal of the fixator. Two arthrodeses were successful. Bone transport showed adequate regeneration. A single radial non-union united successfully. Loosening occurred in 11 wires and breakage in 6. The subacute infections in 11 (27.5%) patients were not due to the fixator itself but to low standards of hygiene and the delay of treatment in the prehospital phase. Reusing the fixator at least three times reduces the cost for the individual patient to US$ 13.60. A locally made fixator is cost-effective and can be recommended for surgical treatment under similar economic situations.