Abstract

MANAGEMENT OF INFECTED NON-UNION OF LONG BONES WITH LIMB RE-CONSTRUCTION SYSTEM

Author(s): Girish Kumar K 1 , Sunil Kumar P. C 2 , Harish Pai 3 , B. G. Sagar 4

Infected nonunion of long bones are a great challenge to treating surgeons. Various factors such as devitalisation of bone, soft tissue scarring, deformity, limb length discrepancy, joint stiffness and secondary osteoporosis need to be addressed along with financial constraints and compliance in management of such situations to choose appropriate treatment. Limb reconstruction system provides single stage, easy to construct and less cumbersome option to the patient. PURPOSE To evaluate safety and efficacy of limb reconstruction system in management of infected nonunion of long bones. STUDY DESIGN/SETTING Retrospective study. METHODS Thirteen patients with infected nonunion of long bones (tibia-8 cases and femur-5 cases) were operated using limb reconstruction system. There were 11 males and 2 females. The average age was 35 years (range 21-50 years). All cases had established nonunion for at least 6 months with evidence of infection. The infection was active in 8 patients and non-draining in 5 patients. Ilizarov study group ASAMI score was used for bone results and functional results. Complications assessed as per Paley classification. RESULTS The mean time for union was 9.8 months (7-12 months). The mean follow up after LRS removal was 35.2 months (range 24- 44 months). Two cases had angulation of about 8 degrees (femur) and remaining cases did not have any angulation. Infection was eradicated in all cases. Functional outcome was excellent in five patients and eight good in patients. Bone outcome was excellent eleven patients and good in two patients. CONCLUSIONS Limb reconstruction system is a safe and effective tool for simultaneous correction of limb length discrepancy; achieve union and infection control in a single stage. It is easy to perform with reliable results and less complications