treatment of infected non union of the tibia by compression distraction techniques using Ilizarov external fixator

The application of ilizarov techniques to diaphyseal infected non unions is very encouraging. It may prove to be an excellent technique for future management of resistant diaphyseal infections of bone. Circular external fixation using the Ilizarov apparatus combined with compression-distraction techniques were used to treat eleven patients with infected non union of the tibia. There were 8 males and 3 females with an average age of 27 years [range 17-51 years]. The average number of previous failed surgical attempts at union was two per patients [range one to four]. of the eleven patients there were 8 with chronic tibial defects; one with normal extremity length; 5 with shortening associated with bone fragment contact and two With bone loss in excess of the amount of shortening. There were three infected non union without shortening treated with complete resection of the non union site and conversion of the diaphysis into a segmental defect. In eleven patients, the infected extremities healed without the addition of a cancellous graft, microvascularfibular or soft tissue grafting. The average length of regenerate gain was 3.7 cm [range 1.5 to 4.9 cm]. Postoperative antibiotics were administered in. 3 out of the eleven patients for 10 days after en block resection of the diaphyseal sequestrae. Functional results were excellent in 5, [45.45%] good in 3, [2 7.2 7%] fair in 2 [18.18%] and poor in only one patient [9.10%] There were no additional bone grafting procedures, microvascular bone transplants, or other grafting techniques used in any patient

Evaluation of the results of reconstruction of chronic anterior Cruciate Ligament insufficiency using a bone - patellar tendon-bone autograft

Reconstruction the Anterior Cruciate Ligament using one-third of the patellar tendon, as a graft has been a popular procedure. Today, the central third of the tendon used as a free graft with a bony plug at each end, is Considered the best procedure Nineteen male patients with a mean age at the time of injury of 24 years [range 18-32 years] were followed up for average of 20 months after operative reconstruction of Chronic cruciate injuries with a minimal arthrotomy using a bone-patellar- tendon-bone autograft. The average duration between the initial injury and the surgery ranged from 1 to 30 months [mean= 13 months]. Initially, 12 patients [63.20%] were classified as competitive and 7 [36.8%] as recreational athletes. At follow-up, 12 patients [63.20%] were satisfied subjectively and .13 [68.4%] were classified objectively as excellent or good on Lysholm's score. Anterior stability was good in 18 knees [94.7%]. The Lachman test showed that 10 cases [52.6%] were completely stable. The test was strongly positive in one patient. The pivot shift test was negative in 14 patients [73.7%] and markedly positive in one [5.3%] and wasting of the thigh was more prominent in 5 patients. So reconstruction of ACL insufficiency with a bone-patellar ligament-bone graft using a miniarthrotomy leads to good stability and good function and most patients will be able to return to their sport activity