Infected nonunion of the humerus treated by the compression distraction ilizarov technique without radical debridement or bone excision: Case series

Abstract

Background: External fixators have been proved to be effective in the treatment of infected nonunion fracture humerus. The current study presents the outcome of treatment of infected nonunion of the humerus by a cyclic compression distraction technique using Ilizarov without radical debridement. Materials and Methods: 32 patients, 19 males and 13 females. The mean age of the patients was 39.72 years (range, 27–54); patients were presented by infected nonunited fracture humerus after an average of 1.9 surgeries (range, 1–4). All patients were treated by removal of the hardware if present without radical debridement or bone resection to avoid bone shortening and to preserve the blood supply of the bone and soft tissue, Ilizarov application with cyclic compression distraction. Results: The mean time of the external fixator application was 179.06 days, and the mean follow-up time was 32.8 months. All patients were united, According to the association for the study and application of the method of the ilizarov scoring system, the functional results were excellent in 8 patients, good in 16, fair in 7, and poor in only 1 patient. The bone results were excellent in 9 patients, good in 16, fair in 5, and poor in 2 patients. The mean post-operative DASH score was 32.43 (range, 10–63), the mean visual analog scale (VAS) score for pain was 3.71 (range: 2–5), while the mean VAS score for satisfaction was 7.41 (range: 6–9). Conclusion: Cyclic compression distraction by Ilizarov without radical debridement had shown a satisfactory outcome in the treatment of infected nonunion humerus. Level of Evidence: IV, A retrospective study.