Results of LRS (Limb Reconstruction System) in Management of Infected Non Unions of Femur

Abstract

Introduction: Infected non-union needs prolonged treatment and repeated surgeries which significantly impacts patient’s social, financial, physical and mental life. In relation to Ilizarov technique monolateral external fixator is less bulky, more comfortable and better tolerated by patient. In this study we aim to assess the union rates, infection control, alignment, complications and the functional outcome of infected femoral non-union managed with monolateral external fixator. Material and methods: This is a prospective interventional study carried out between June 2017 and June 2021 at tertiary care centre operated by a single surgeon. Patients diagnosed as infected non-union of femur clinically and radiologically and operated with monolateral external fixator were assessed. Functional and radiological assessment was done using ASAMI classification. Results: In our study 21 patients were operated which included 20 males (95.2%) and one female with mean follow up is 29.85 ± 11.42 months. The most common site of non-union is mid-shaft of the femur. The mean bone defect after debridement is 3.52 ± 2.23cm (1 -10cm). The mean time of bony union in our study is 180.65 days (range 95-740 days). The ASAMI classification of bone results is Excellent to good in 90% of patients. Conclusion: Our study suggested that the Limb reconstruction system can be successfully used in the management of infected non-union of femur as a stable fixation modality and achieve satisfactory outcome in terms of bony union and functional results. Pre-operatively planning of the LRS frame, radical debridement and maintaining stability of the LRS frame are key steps of the treatment.