Salvage of Complicated Diaphyseal Femoral Fractures by 1-Stage Open Debridement and Ilizarov Technique

Abstract

Infected femoral shaft fractures and femoral nonunions are difficult to manage. In the presence of associated segmental bony defects, limb length discrepancy, or complex deformities, Ilizarov techniques seem to be the ideal choice for management. We would like to describe small case series of 3 patients managed using Ilizarov techniques: the first patient with infected nonunion of a femoral shaft fracture over an interlocking nail, the second patient with infected femoral shaft plating, and the third with longstanding femoral shaft hypertrophic nonunion who had multiple surgeries and presented at the end with a broken intramedullary nail. The principal management in all cases was a single-stage aggressive debridement and fixation using circular Ilizarov external fixator or hybrid external fixator followed by either segmental bone transport for the first 2 patients or monofocal compression distraction for the third patient. The end result was clinical and radiological union in all patients with equalization of the limb length.