Outcomes of mono-lateral limb reconstruction system in infected non-union of long bones

Abstract

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">We planned to evaluate functional and radiological outcomes of mono-lateral limb reconstruction system for infected non-union of long bones and to analyse its complications occurring.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">It was a prospective study, conducted during period of September 2015 to August 2017 and consisted of 73 cases of these 60 cases were available for final assessment. This infected non-union were classified by AO classification and were treated with mono lateral limb reconstruction system. All the cases were evaluated by ASAMI criteria for bony and functional outcomes. Our mean follow up period was 16.8 months</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 60 cases of infected non-union with mono-lateral external fixator were followed for mean 16.8 months. According to these ASAMI criteria in our study 26.6% had excellent; 46.6% had good; 16.6% fair; and 10% poor bony outcome. And the functional outcomes were 13.3%, 60%, 16.6%, 10% were excellent, good, fair and poor respectively. <span lang="EN-IN">Among the cases 50% had pin tract infections and loosening. Two cases pin revision was done. Sinus tract got cleared in all cases except 6 where multiple sinus tracts were present and healing did not occur. There were no infections at the corticotomy site. Delay in the consolidation phase was present in all cases. There was no difficulty in transportation of bone. Post-operatively wound dehiscence in eight cases was managed with split skin graft cover. Limb length discrepancy upto 2.5 cms in lower limb was managed with modified footwear with heel and sole raise. Non-healing fractures united in mean 5.9 months after start of treatment. Non-union site united in 90% cases. </span><strong>Conclusions:</strong> <span lang="EN-IN">Mono-lateral limb reconstruction system is efficient method for treatment of infected non-union of long bones. It has an additional advantage of correcting limb length discrepancies which sometimes occur during the course of treatment.</span></p><p class="keywords"><strong>Keywords: </strong>Non-union, Infection, Long bones, Limb reconstruction system, External fixator</p>

Functional and Radiological outcome of Limb Reconstruction system (LRS) in infected nonunion of Tibia

“…13 In our Study treatment of Fig. 2: Resected infected bone segment with corticotomy infected non-union of tibia 90% patient showed successful Union in 8 to 12weeks period which is comparable to other studies Garcia-Climbrelo et al, 14 Gajbhiye AI et al, 15 and Patil S et al 16 In majority of the patients range of motion was not much impaired. Average follow-up was for the 18 months ranging from 12 to 24 months study is comparable to Ajmera A et.al.…”

Study of limb reconstruction system in infected and gap nonunion: At tertiary care centre

“…Patients with limb length discrepancy up to 2 cm in lower limb managed with modified footwear with shoe raise. The results were divided into bony results and functional results, according to the classification of the ASAMI [4,7] (Association for the study and application of the method of Ilizarov). ASAMI'S criteria were used to analyze the results in our study.…”

“…As in other series functional results were inferior to bony results. An excellent bone results does not guarantee a good functional result [4] . As to the 11 cases where there was rigidity of ankle/knee, it must be noted that eight were preexistent and 3 were post treatment.…”

“…Those Excluded who having Non unions due to congenital disorders, All pathological fractures with nonunion, Hypertrophic nonunion, Articular and periarticular nonunion (within 2cm from joint) [22] and Aseptic nonunion. In this study, infected and gap nonunion were categorized by the AO classification [4,5] . According to this classification, Patients with wounds that had no discharge for 3 months were called as non-draining (Quiescent).…”

“…The incidence also seems to be increasing especially in view of increasing high velocity trauma, which is more frequently treated with internal fixation. Soft tissue loss with multiple sinuses [3,4] , osteomyelitis, osteoporosis, complex deformities with limb length inequality, stiffness of the adjacent joints and multidrug resistant infection all complicate treatment and recovery. These factors make an unfavourable milieu for fracture union.…”