Infected fracture non-union of long bones management by distraction osteogenesis using limb reconstruction external fixator system - case series

INTRODUCTION Nonunion is diagnosed when fracture failed to show any clinical or radiological attempt of union beyond the expected time. Nonunion was more common with open, infected, segmental, severely comminuted, insecurely fixed fractures. In infected nonunion, bone defects, limb shortening, deformity and soft tissue problems pose a great challenge in management. OUR SERIES This is a prospective follow up consisting of 9 cases, ranging from 20 to 65 yrs, with male to female ratio of 3.51 and mean follow up of 11 months. The mean limb length discrepancy noted in our series was 3.2 cm. corticotomy after thorough debridement and distraction osteogenesis. RESULTS The results were divided into bony results and functional results, according to the classification of the ASAMI (Association for the study and application of the method of Ilizarov). The bony result was fair to excellent in 80 and functional result was fair to excellent in 74. Union time ranged from 4 to 8 months (mean 4.9 months). There were no neurological or vascular injury as a result of instrumentation. CONCLUSION In our series, we could achieve a success rate of 80, giving good encouraging results to most of our patients. This can also be used to correct the limb length discrepancies and soft tissue problems simultaneously during the course of the treatment. Hence we conclude that limb reconstruction external fixator system (LRS) is effective and convenient method for the treatment of infected nonunion of long bones.