Limb reconstruction system (LRS) in infected non union of femur: A case series

Abstract

Objective: To evaluate the clinical and functional outcomes of limb reconstruction system (LRS) in infected non union of femur.Background: LRS is an effective alternative in treating the failed osteosynthesis in long bone fractures, due to infection, loosening of implant, non union, poor bone quality and bone loss associated with deformities, limb length discrepancy, soft tissue problems, and functional issues.Methods: We did a prospective study of 30 cases of infected non union of femur (10 plating, 19 nailing & 1 k-wire with plaster) between April 2014 to November 2018 treated with LRS. Initially we managed by implant removal, freshening of fracture site or radical debridement followed by LRS application. In 13 cases corticotomy & lengthening was performed. Monofocal lengthening was done in 5 cases. Bifocal corticotomy done in 8 cases. Average duration of frame was 14 months (8-18 months).Results: Bone united in 24 cases (80%), Number of cases underwent lengthening -14. Average lengthening achieved-5 cm (2-11 cm). We had 86% excellent and 10 % poor bony result. Functional result was excellent in 40%, good in 50% and failure in 10% cases according to ASAMI scoring system.Conclusions: LRS is found to be effective in managing infected non union in long bones because of its simplicity, short learning curve, ease of use with better patient compliance and is an alternative to Ilizarov.