Abstract
Objective:To document the presentation of tibial infected non-union and analyze the management outcome with Ilizarov technique in terms of bone results, functional outcome, bone transport time, external fixation time, external fixation index and any complications.Methods:This case series was conducted at the Departments of Orthopedic Surgery, National Institute of Rehabilitation Medicine (NIRM), Islamabad and Civil hospital, Quetta over a period of 3-years.Results:There were 56 patients with 53(94.64%) males and 3(5.35%) females. The age range was 16-50 years with a mean of 32.58±9.98years. According to ASAMI criteria, bone results were excellent in 37(66%), good in 10(17.85%), fair in 6(10.71%) and poor in 3(5.35%). The functional results were excellent in 37(66%), good in 9(16%), fair in 7(12.5%) and poor in 3(5.35%). The bone union rate was 98.21%.Conclusion:Ilizarov method beautifully addresses the formidable issue of infected non union of tibia with good outcome in terms of bone healing and infection eradication. The treatment period is relatively lengthy and hence patience on part of patient as well as the surgical team is imperative for achieving favourable outcomes.
Highlights
Trauma continues to plague the World at large and the low income countries like ours (Pakistan) in particular. It results in frequent mortality as well as high morbidity owing to the associated soft tissue and skeletal injuries
The study was conducted after approval from the hospital ethics committees of the hospitals. It included all patients who presented with infected tibial non-union at the two hospitals and were managed with Ilizarov technique
According to ASAMI criteria, bone results were excellent in 37(66%), good in 10(17.85%), fair in 6(10.71%) and poor in 3(5.35%)
Summary
Trauma continues to plague the World at large and the low income countries like ours (Pakistan) in particular. It results in frequent mortality as well as high morbidity owing to the associated soft tissue and skeletal injuries. Tibial fractures and subsequent non-unions are not uncommon in the aftermath of such high-energy trauma to the lower limbs. The infected tibial non-unions often pose management challenges to the orthopedic surgeon and his teams. A variety of factors may underlie this problem. An initial gross contamination of the wound, inadequate initial management, smoking, diabetes mellitus, malnutrition, osteoporosis and any other factors that adversely affect the process of wound healing.[1,2,3]
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