Functional outcome of distraction osteogenesis in infected nonunion of the tibia

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Abstract Background: The tibia is a bone located beneath the skin. Open fractures of the tibia, which involve significant soft tissue damage and bone loss, pose a challenge for trauma surgeons. The prevalence of long bone fractures is on the rise, attributed to the escalating number of road traffic accidents and other household mishaps, resulting in an increased occurrence of nonunion cases. Consequently, this study aims to evaluate the healing rates in long bone nonunion fractures and examine the complications associated with the treatment device. Managing infected tibial nonunions remains a formidable task for orthopedic surgeons. Materials and Methods: A retrospective study was conducted on 30 patients diagnosed with infected nonunion of tibial fractures treated with limb reconstruction systems (LRSs) in the Department of Orthopaedics at Vinayaka Missions Kirupananda Variyar Medical College and Hospital, Salem, Tamil Nadu, India. Inclusion criteria comprised patients aged between 20 and 55 years with tibial fractures failing to unite within 6 months, radiological evidence of nonunion, willingness to provide written informed consent and suitability for surgery. Results: The results revealed that most patients fell within the age group of 40–50 years, with an average age of 40.9 years in our study. Out of 30 patients, 17 were male and 13 were female. Regarding bony results, 20 patients (66.7%) exhibited excellent outcomes, 6 patients (20%) showed good results, 3 patients (10%) had fair outcomes, and 1 patient (3.3%) had poor outcomes. Functional outcomes showed that 20 patients (66.7%) experienced excellent results, 6 patients (20%) showed good outcomes, 3 patients (10%) had fair outcomes, and 1 patient (3.3%) had poor outcomes. Conclusion: This study concludes that the LRS fixator facilitates early ambulation, reducing the risk of osteoporosis, and soft tissue dystrophy. The average union time was 4 months, influenced by comminution, infection, nonunion type, smoking, and fracture pattern.