EVALUATION ON THE MANAGEMENT OF INFECTED NONUNION

AND GAP NONUNION FRACTURE OF LONG BONES BY ILIZAROV

METHOD
Prof.R.selvaraj, P.Balasubramaniyan.
Dept.of Orthopaedics, Stanley Medical College, Chennai, Tamil Nadu
ABSTRACT
INTRODUCTION:
Management of infected non-union and gap non-union fracture of long
bones is a great challenge to orthopaedic surgeons. Infected non-union of fractures
is not a single problem and it is associated with multiple problems like infections,
bone defects, limb length discrepancies, deformities and soft tissue problems like
scaring, discharging sinuses, etc. Duration of treatment and cost creates a huge
burden to the patient as well as treating institution. Ilizarov address all the problems
simultaneously. Distraction osteogenesis following corticotomy helps in filling the
bone defects, eradicating the infection and promote fracture healing
KEY WORDS:
Infected non-union, Ilizarov ring fixation ,distraction osteogenesis,
corticotomy.
MATERIALS AND METHODS:
This Prospective study was conducted at The department of Orthopaedics,
Stanley medical college, Chennai, Tamil Nadu during the period August 2015 to
July 2016. In our study includes 20 cases with 18 males and 2 females admitted
with infected non-union fracture of long bones, gap non-union fracture of long
bones due to various causes was treated by Ilizarov ring fixation method and were
studied for the functional outcome, complications and fracture union. The results
were evaluated using the criteria laid down by The Association for The Study and
Application of the Methods of Ilizarov ( ASAMI) Scoring system.
RESULTS:
Bone healing was excellent in 75% of cases, good in 20%, fair in 5% and
none of cases have poor results. Functional results were excellent in 40% and good
in 55% , fair in 5% of cases and none of cases show poor results. Limb length
discrepancies and joint stiffness are the common complications.
CONCLUSIONS:
The goal in treatment of infected non-union and gap non-union is to have a
well aligned, painless, healed and functional limb. Ilizarov ring fixation is the
better option in treatment of infected non-union and gap non-union. Considering
the complexity of problems , it is the treatment of choice as it address the problems
associated with infected non-union and gap non-union of fracture. Sound patient
selection with realistic treatment goals is the key for successful management.