Management of Infected Nonunion of Long Bones by Bifocal Osteosynthesis of Ilizarov’s Principle with the Limb Reconstruction System
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 11
Abstract
Abstract: Nonunion of long bone fractures has become a common problem in orthopaedic practice. Nonunion of a fracture can occur both in conservative as well as in operative treatment. When infection is added to nonunion, the condition becomes intractable. The treatment gets prolonged over many years and sometimes it ends in amputation. This study aims to treat the intractable infected non-union of long bones by bifocal osteosynthesis of Ilizarov’s principle with Limb Reconstruction System. We conducted a prospective study on infected nonunions of long bones with 20 patients. All cases of femur and tibia were considered between the age group of 27 and 50 years. Limb reconstruction system was used in all the patients along with corticotomy was done as a preferred choice of fixation. All the 20 cases presented to us with discharging sinus except one case. 2 cases out of 20 cases went stiff nonunion. 18 cases out of 20 cases were mobile nonunion. Our follow up varies from 4 months to 12 months, with an average of 8 months. The nonunion site united in all the cases by the end of 16th week. The sinus got cleared in all the 20 cases by the end of 9th week. There was no difficulty in this series as far as the transportation phase in concerned. There was a considerably delay in the consolidation phase in all cases. Of them, 4 cases had pin tract infection. Hence the fixator was removed and functional cast brace was applied. After a period of waiting for the consolidation to occur, the final result of the healing of the osteotomy with good bone healing in about 12 cases, a delay in healing in 6 cases, 2 cases had delayed union, which needed bone grafting. In all the cases, there was no infection in the osteotomy site.The method of treatment of infected non-union by the monoliteral external fixator with a predictable healing of nonunion and control of infection is well shown in this study. Though there are some complications with this method, it can be overcome by careful preoperative planning, appropriate surgical techniques and adequate follow-up, which will definitely make this method a very successful one. Keywords: Limb reconstruction system, External fixator, Ilizarov’s fixation, Infected nonunions.
Authors and Affiliations
Duppala Manoj Kumar
Keywords
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