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

ABSTRACT

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