Trends in Clinical and Medical Sciences
Special issue: Recent developments of medical and surgical research (2023), pp. 502 – 506
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr069
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr069
Management of infected non-unions of long bones with ilizarov external fixator: Our experience
Vivek Sharma\(^{1,*}\), Pankaj Spolia\(^{1}\), J Sikdar\(^{2}\) and Ravinder Singh\(^{2}\)
\(^{1}\) Department of Orthopaedics, Govt. Medical college Kathua (Distt-Kathua), Jammu and Kashmir, India, PIN: 184102.
\(^{2}\) Department of Orthopaedics, M.M. Institute of Medical Sciences and Research, Mullana, (Distt-Ambala), Haryana, India, PIN:133203.
Correspondence should be addressed to Vivek Sharma at sharmavivek1979@yahoo.com
Copyright © 2023 Vivek Sharma, Pankaj Spolia, J Sikdar and Ravinder Singh. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: February 9, 2023 – Accepted: May 18, 2023 – Published: May 27, 2023
Abstract
Background: Infected non-union and gap non-union are challenges that orthopaedic surgeons have to face globally. The open fracture is the most common cause of infected nonunion and tibia is the most commonly involved bone in the infected nonunion. In Ilizarov technique, vascularity is increased by corticotomy and application of a circular external fixator. It also provides micro motion due to distraction and gives an excellent biological environment for fracture healing.
Material and Methods: Seventeen consecutive patients with infected nonunion of long bones were treated from 2012 to 2016. The age range was 20 to 65 year-old male patients. Five cases were admitted with femoral infected non-union and twelve with septic non-union of tibia. Patients were followed up for one year. The predominant bacteria were Staphylococcus aureus and Pseudomonas aeruginosa. Average duration of antibiotics treatment was 4.9 (range, 2-6) weeks. The outcome measures were according to the classification of ASAMI, which is based on radiological (defect filling) and clinical (functional) findings.
Results: The cases were followed with mean period of 3.5 years (range, 2-5 years). In the present study, seventeen cases with septic non union of tibia and femur were evaluated. All cases completed treatment and achieved bony union with no signs of infection. In the present study, bone union result as per ASAMI score was excellent in 76.5%, good in 23.5% cases, and also the functional results were excellent in 76.5%, good in 23.5% cases. No patient had gone for amputation in our study.
Conclusion: Ilizarov technique has been a successful treatment for infected long bone non unions of tibia and femur associated with bone loss. Our results were similar with the existing literature about the study. The lengthy treatment time and considerable number of complications must be fully understood both by the surgeon and the patient before undertaking the ilizarov treatment method.
Material and Methods: Seventeen consecutive patients with infected nonunion of long bones were treated from 2012 to 2016. The age range was 20 to 65 year-old male patients. Five cases were admitted with femoral infected non-union and twelve with septic non-union of tibia. Patients were followed up for one year. The predominant bacteria were Staphylococcus aureus and Pseudomonas aeruginosa. Average duration of antibiotics treatment was 4.9 (range, 2-6) weeks. The outcome measures were according to the classification of ASAMI, which is based on radiological (defect filling) and clinical (functional) findings.
Results: The cases were followed with mean period of 3.5 years (range, 2-5 years). In the present study, seventeen cases with septic non union of tibia and femur were evaluated. All cases completed treatment and achieved bony union with no signs of infection. In the present study, bone union result as per ASAMI score was excellent in 76.5%, good in 23.5% cases, and also the functional results were excellent in 76.5%, good in 23.5% cases. No patient had gone for amputation in our study.
Conclusion: Ilizarov technique has been a successful treatment for infected long bone non unions of tibia and femur associated with bone loss. Our results were similar with the existing literature about the study. The lengthy treatment time and considerable number of complications must be fully understood both by the surgeon and the patient before undertaking the ilizarov treatment method.
Keywords:
Ilizarov; Infected non-union; Femur; Tibia.