A study of management of non union of long bone fractures by limb reconstruction system

Abstract

Background: Management of non-unions is difficult due to the presence of infection, deformities, shortening and multiple surgeries in the past. Non-union are traditionally managed by illizarov fixation. All the procedures used to treat non-union have their own set of complications like shortening, soft tissue infections, multiple surgeries, chronic infection, increased morbidity, increased hospital stay. We conducted a study on 20 patients with long bone with non-union treated with a Limb reconstruction system (LRS). Material and Method: We treated 20 patients of non-union long bones with a limb reconstruction system (LRS). In this study, 18 were male and 2 were female. All patients were operated on under spinal-epidural anaesthesia in supine position. Patients were evaluated at pre-op and post-op follow-up period with serial radiography on 6 weeks 12 weeks 6 months and 9 months. Initially, 12 patients that presented with infected implant were managed with implant removal radical debridement and fixation with LRS. In 8 cases, corticotomy and lengthening were done. The average duration of treatment was 9 months. The outcome was evaluated with the ASAMI scoring system. Result: The union occurred in 90% of patients and eradication of infection in 95% of patients, We had 80% excellent,10% good and 10% poor bony union results according to the ASAMI scoring system and the Functional outcome was excellent in 80% patients, good in 10% and failure in10% cases using ILIZAROV functional scoring system. Conclusion: LRS is a good alternative to the illizarov fixation in managing infected and non-infective non-union of a long bone. It is less cumbersome, uniplanar and surgeon friendly.