Treatment of tibial and femoral infected non union by the Ilizarov technique

ABSTRACT

Experience in 33 cases all were done in our Orthopedic Department, Zagazig University Hospital.Ilizarov circular external fixator creating internal bone transport or compression distraction techniques were used to treat 33 patients with infected non unions or segmental bone loss. There were 20 tibial and 13 femoral. Their mean age was 38 [11-60] years and there were 25 men and 8 women. 25 patients had active infection with drainage and 8 were previously infected. After resection of the infected and necrotic bone, the intercalate defect averaged 5 [3-10] cm. The mean duration of treatment was 11 [4-18 months]. Regeneration of the distraction gap was achieved in all 33 patients. Union at the target zone was achieved in 29 and in the remaining four cases consolidation were achieved after application of autogenous bone grafts. The infection was eradicated in all cases.Complications were not severe and did not affect the final results. Residual malalignment remained in three patients, two femoral with 10° and 8° varus deformity and one tibial with 11° valgus deformity. The final leg-length discrepancy never exceed one cm. Residual fixed flexion deformity of the knee was left in two cases, but only ranges from 5° - 10° and loss of ankle dorsiflexion in three patients. There were no intraoperative or postoperative neurovascular damage or compartment syndrome.Psychological intolerance was seen in one young patient and delayed union in four cases. Almost patients returned to their previous occupation. So, we may prove also that radical debridment and bone transport is a simple and safe method for successful treatment of infected non union