Prospective evaluation of the role of limb reconstruction system in fracture non-union of femur: a case series

Abstract

Traditionally the Ilizarov’s ring fixator was used in the management of non-union of long bones, especially in the cases with infection. But limb reconstruction system (LRS) is a viable lightweight, technically easier alternative for the same. The aim of this study was to assess the functional outcome, the radiological outcome and the complications associated with the management of fracture non-union femur treated with LRS. A prospective case series was undertaken comprising of 10 patients. Both infected and non-infected shaft of femur fractures were enrolled. Patients underwent debridement, implant removal and definitive fixation with LRS. Post-operative radiological outcome and functional outcome using the ASAMI (Association for the Study and Application of the Method of Ilizarov group) score. In 70% cases the mechanism of injury was road traffic accident. Mean period of non-union before admission was 11.9 months, mean time for union was 10.10 months, with 90.0% cases successfully uniting. 70% cases underwent lengthening following Ilizarov’s principles. ASAMI radiological outcome was excellent in 70%, good in 10%, fair in 10% and poor in 10% cases. ASAMI functional outcome was excellent in 60%, good in 10%, fair in 10% and poor in 20% cases. Pin tract infection was the most common problem at 70.0% while knee stiffness at 40% was the most common true complication. Thus by this study it can be expressed that LRS is a feasible alternative to ring fixators for the management of fracture non-union shaft of femur.