English

Abstract

Infected non-union has been defined as a state of failure of union and persistent infection at the fracture site for 6-8months 1 and union is not likely to occur without active intervention. Infected non-union has been a challenge in orthopaedic surgical care. Open debridement of the infected non-union site appropriate antibiotics and stabilization of fracture are the basic principles of treatment in an infected non-union. Internal fixation of such fracture is fraught with recurrence and or persistence of infection as the implant so placed will act as a foreign body. The best way to stabilize such a fracture is with an external fixation. External fixation so used should not only stabilize the fracture but should also take the cyclical loading of day to day activities and also weight bearing. MATERIALS AND METHODS: In this study 18 cases of infected non-union of long bones were treated from 2009 to 2012. Their age ranged from 22 to 51. There were 13 male and 5 female patients. Basic principles followed in the treatment. 1. Elimination of infection by physical debridement removal of implants if any and antibiotic treatment based on culture sensitivity reports. 2. Stabilization of fracture to give the fracture area rest and allow it to heal. 3. Restoration of function of the limb and also the adjacent joints. RESULTS: 17 of the 18 patients had good results. Patient had to be treated with amputation as the infection was severe. CONCLUSION: Based on our study, experience and also after reviewing the published reports we conclude that Best treatment for infection is Prevention. Treatment infected non-union is a long drawn battle. It needs an aggressive approach and a lot of patience from the patient. Basic treatment protocol for infected non-union is thorough debridement, removal of all infected material including the internal fixation devices. Long duration antibiotics treatment as per the culture and sensitivity pattern. Fracture stabilized with external fixation. Monolateral external fixators like LRS are equally effective and a good modality of treatment in infected non-union of long bone fractures. Treatment of Infected non-union of long