Treatment of infected nonunion tibia by ilizarov external fixator

ABSTRACT

Nonunion of the tibia associated with infection have always been a challenge to orthopedic surgeons. The ideal treatment should be comprehensive with the ability to simultaneously tackle axial deviations shortening, bone loss, poor local vascularity and achieve bony union without further compromising the soft tissue envelope. All of the above should be achieved by using Ilizarov external fixator in treatment of infected nonunion tibia by compression distraction technique. From 2005 to 2007; 25 patients with infected nonunion tibia were treated by Ilizarov external fixator. Of 25 infected nonunion tibia, 18 were diaphyseal, 7 were metaphyseal, 22 after open fractures and 3 after closed fractures, 5 nonunion with quiescent infection with no drainage, and 20 active infection with drainage, with infection developed after internal fixation in 15 cases, after external fixator in 7 cases and after casting in 3 cases. The mean duration of treatment was 12 months. The duration of follow up ranged 12 to 38 months [mean 22 months]. The mean time of union were 9 months [range 4-11 months]. Bone deformity was corrected in all patients except in 2 with residual deformity less than 5 degrees. The bone result was excellent in 18 cases, good in 6 cases, and fair in 1 case. The functional results were excellent in 15 cases, good in 5 cases, and fair in 5 cases