The management of displaced distal tibial fractures is still controversial. The different internal 
fixation techniques are often burdened by relatively high complication rates. Minimally invasive 
techniques with ring fixators have been introduced as an alternative allowing immediate reduction and 
stabilization, avoiding a staged protocol. The aim of this prospective study was to analyze the clinical 
and radiographic outcome the Ilizarov technique in patients with distal tibial fractures. Twelve 
patients with distal tibial fractures treated with the Ilizarov technique, the mean follow up period was 
12 months (ranged from 6 to 24 months). Depending on the type of fracture, 3 or 4 rings were used. 
Unrestricted weight-bearing was allowed in all cases at 6 weeks. Pre- and post operatively 
conventional radiographs, post-operative pain assessment and complications were evaluated. 
Clinical outcomes were evaluated according to the ankle-hindfoot score devised by the American 
Orthopaedic Foot and Ankle Society (AOFAS). No patient developed compartment syndrome or deep 
venous thrombosis. Pin infections were frequent, but they were mostly superficial and were treated 
with antibiotics and local antiseptics. 2 cases of malunion occurred, one of them required ankle 
fusion, the fixator was removed after a mean of 20 weeks (range 12–28). The clinical outcome 
according to AOFAS score was excellent in 6 patients, good in 3, fair in 2 and poor in 1.