Abstract

Introduction: Tibia is the most common long bone fractured due its vulnerable subcutaneous location and most often associated with acquired complications of delayed union or non-union due to infection. Amongst the various treatment options to treat them, the Ilizarov external fixator application is considered superior due to its multiple advantages. The objective of this study was to analyse the role of Ilizarov fixation in infected tibial non-union, as well as to assess bony union and associated functional outcomes.Materials and Methods: A retrospective review was conducted for the duration between 1st January 2005 to 31st December 2016. Total of fifty-one patients with tibial non-union associated with infection who treated with the Ilizarov fixator were included in the study. Patient records were reviewed for union of bone, bone and functional outcomes and complications.Results: The most common organism for infection was identified to be Staphylococcus Aureus. At the time of final follow-up all patients had achieved union except two, one of whom had to undergo amputation due to non-union and sepsis. Majority of the patients had an excellent score as per ASAMI grading system for bone and function results. The most common complication noted was pin track infections.Conclusion: In our experience, Ilizarov external fixator is better suited for infected non-union of tibia because it can provide a stable mechanical environment, bone transport, correct deformities, and enable weight bearing and hence we recommend its use for the same.

Highlights

  • Tibia is the most common long bone fractured due its vulnerable subcutaneous location and most often associated with acquired complications of delayed union or non-union due to infection

  • The Ilizarov method has certain advantages as it can overcome most of the difficulties; it can compensate for bony defects, allow for bony union through bone histogenesis as well as eliminate infection[7]

  • The primary aim of this study was to analyse the role of Ilizarov fixation in infected tibial non-union, as well as to assess infection rates, bony union, functional outcomes and associated complications

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Summary

Introduction

Tibia is the most common long bone fractured due its vulnerable subcutaneous location and most often associated with acquired complications of delayed union or non-union due to infection. The objective of this study was to analyse the role of Ilizarov fixation in infected tibial non-union, as well as to assess bony union and associated functional outcomes. Total of fifty-one patients with tibial non-union associated with infection who treated with the Ilizarov fixator were included in the study. There are different options available for the management of chronic diaphyseal infections associated with non-union which include extensive debridement with local soft-tissue rotational flaps[5], packing the defect with antibiotic cement beads, Papineau-type open cancellous bone grafting[6], tibiofibular synostosis, free microvascular soft-tissue and bone transplants and the Ilizarov method. The Ilizarov method has certain advantages as it can overcome most of the difficulties; it can compensate for bony defects, allow for bony union through bone histogenesis as well as eliminate infection[7]

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