الفهرس 
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Abstract
Segmental fractures are among the most difficult groups of fractures. Usually, they occur in traffic accidents due to the effect of direct violent forces. They are uncommon, but present difficulties in management because of the wide zone of injury, potentially reduced viability of the bone and problems with stabilization.
These high-energy fractures are likely to be associated with injuries elsewhere. Because of the damage of both intramedullary and periostal vascularization, segmental fractures are predisposed to slow healing and development of pseudoarthrosis
Various methods of treatment have been proposed including casting and functional bracing, internal fixation by plates and screws, intramedullary nailing and external fixation.
External fixation has the potential to provide multilevel stabilization of the fracture with minimal disruption of the soft-tissue envelope. Circular external fixation gives multiplanar control which is absent from monolateral designs.
Aim of the work:
The aim of this study is to evaluate treatment of patients with segmental tibial fractures using Illizarov External Fixator.
Patients and methods:
This study included thirty cases of segmental tibial fractures, their ages ranged from 18 to 60 years old with mean age of 33.47. All the patients were males. 25 cases were open fractures and 5 cases were closed fractures. Number of segments ranged from 3 to 5 segments. Time between injury and operation ranged from 1 to 7 days and duration of Ilizarov ranged from 7 to 9 months.
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Summary
Ilizarov fixator was done for all patients at Shiben Elkom teaching hospital. The results were analyzed according to the protocol of the Association for the Study and Application of the Method of Ilizarov (ASAMI).
The bone results were excellent in 15 patients (50%), good in 6 patients (20%), fair in 7 patients (23.4%) and poor in 2 patients (6.6%).
The Functional results were excellent in 15 patients (50%), good in 10 patients (33.4%), fair in 3 patients (10%) and poor in 2 patients (6.6%).
Analysis of follow up X-rays should detect any angularity deformities and all efforts must be made to correct them probably. Pin tract infection should be managed early to avoid bone infection.
Bone grafts shouldn’t be a routine maneuver with Ilizarov and adequate compression distraction techniques uniformly contacted bone ends is enough to achieve union.
In general the results of our study were comparable to the reported results. We had a high union rate and the reoperation rate of our cases was very low.