Ilizarov external fixation and then nailing in management of infected nonunions of the tibial shaft

The Journal of Trauma
Khaled M Emara, Mohamed Farouk Allam


Ilizarov technique is useful in the management of infected nonunions of the tibia. Its main drawback is the long duration of external fixation (EF) with marked patient discomfort. Several techniques have been described for early removal of EF to avoid this problem. Between September 2000 and October 2001, a prospective study at a tertiary trauma center was performed. Thirty-three patients with infected nonunion of the tibial shaft were included. The eradication of infection was by debridement, followed by limb reconstruction using segment transport technique with Ilizarov EF system. When the transported segment reached the docking site, we offered the patients removal of EF, and replacement by intramedullary (I M) fixation with bone graft at the docking site. Advantages and risks were explained to all patients. Patients (N = 17) who accepted this technique were compared with patients (N = 16) who preferred to continue in EF till full bone union, with bone graft at the docking site used in both groups. Mean age of the patients was 29 years, and mean duration of nonunion was 12.6 (range, 6-22) months. Average duration of follow-up from the date of presentation was 36 (range, 22-48) months. Main outcome measurements were assessmen...Continue Reading


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Related Concepts

Bone Diseases, Infectious
Intramedullary Nailing
Fractures, Ununited
Tibial Fractures
Incidence Studies
External Fixation Devices
Fracture Healing
Ilizarov Technique
Device Removal

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