A prospective study on the role of limb reconstruction System in infective non-union of femur and tibia

Abstract

Introduction: Infected non-union of long bones is the state of failure of union and the persistence of infection at the fracture site for a period of 6 to 8 months or more. This condition possesses a challenge for optimal treatment to the orthopaedic surgeon. Limb reconstruction system (LRS) is a single bar device with telescoping facility which allows increased axial movement at the fracture site by permitting conversion from rigid to dynamic fixation resulting in formation of external bridging callus. The regenerated bone restores length and eliminates infection. This procedure does not require much expertise of the treating orthopaedic surgeon and is associated with high patient compliance.Materials and Methods: 20 adult patients with infective non-union of femur and tibia were admitted in Silchar Medical College and Hospital, Silchar between September 2019 to August 2020 after being diagnosed clinically and radiologically as infective non-union. Preoperative radiographs were taken to assess the type of non-union, presence of infection, implants, quality of bone stock and level of non-union. Patients were classified according to the classification by Rosen et al. in the A.O. manual into quiescent, active and draining types. Follow up was done every 4 weeks and Association for the Study and Application of Methods of Ilizarov (ASAMI) score was used to categorize the outcome into excellent, good, fair and poor.Results: It was observed that 90% patients showed excellent to good functional as well as bone healing outcomes.Discussion: Results of mean bony transport, mean implant index and outcomes are comparable to previous studies conducted.Conclusion: LRS application to infective non-union of long bones is a cost-effective procedure which favours both the surgeon and patient as compared to other available treatment modalities.