Functional and Radiological outcome of Limb Reconstruction system (LRS) in infected nonunion of Tibia

Abstract

Introduction: Infected non-union of tibial diaphysis has been a challenging problem. Tibia being subcutaneous bone, fracture healing especially following compound fracture with any pre or postoperative infection leads to notorious non union. Though there have been various treatment modalities to deal with the condition, Limb reconstruction system (LRS) provides simple effective and versatile treatment modality where liberal resection of long segment of infected bone, can be reproduced by combining the masquelet technique with the distraction osteogenesis. It’s light weight and allows better wound management, makes it more patients compliant. Materials and Methods: In this retrospective study, 20 patients of infected non-union of tibial diaphysis were treated by using the Limb reconstruction system during April 2017 to may 2019 at our institute. The final assessment was done upon only those patients who were followed for at least one year post-operatively, using Association for the Study and Application of Methods of Ilizarov (ASAMI) score. Results: According to ASAMI score, bony results were excellent in 75%, good in10%, fair in 5% and poor in 10% and functional results were excellent in 60%, good in 20%, fair in 10% and poor in 10% of patients. The mean bone resection was 7.3 cm, the mean duration of bone transport was 10.4 weeks, the mean bony union time was 11.1 weeks and the mean duration of consolidation of regenerate was 37.8 weeks. Conclusion: The LRS is simple effective and versatile treatment modality in infected non-union of tibia. Itnot only provides bone transport, fusion of the bone ends and finally consolidation of the regenerate on itself but also facilitates in dealing with limb length discrepancies along with early mobilization and better wound management. Keywords: LRS, Infected non-union, Bone regenerate, Resected bone, ASAMI score.