War-related infected tibial nonunion with bone and soft-tissue loss treated with bone transport using the Ilizarov method

Archives of Orthopaedic and Trauma Surgery
Marko BumbasirevićHenry Dushan E Atkinson

Abstract

This single centre retrospective study reviews the outcomes of 30 war-injured patients with established infected tibial nonunion after sustaining grade IIIB open fractures. Patients were treated by radical bony and soft-tissue resection and bone transport using the Ilizarov bifocal technique, without the use of systemic antibiotics or bone grafting. The series comprised 29 males and 1 female with a mean age of 30.4 years and a mean nonunion of 8.6 months at index operation. Patients had previously undergone a mean of 1.3 operations (range 1-3), and the mean size of tibial defect was 6.9 cm (range 4-11 cm) post radical debridement. Bony union was achieved at the tibial docking sites after a mean of 4.5 months in 29 patients (97%) and frames were worn for a mean of 9.7 months (range 7.2-15 months), giving a mean fixation index of 1.48 months/cm. One patient failed to unite at their tibial docking site. Soft-tissue transport successfully closed the soft-tissue defects in all but four patients, who required split-skin grafting. According to the Paley scoring system 19 patients had excellent bony results, 10 good and 1 poor; the functional results were excellent in 13 patients, good in 14, fair in 2 and poor in 1; and there were 1.4...Continue Reading

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Citations

Mar 7, 2013·Archives of Orthopaedic and Trauma Surgery·Dietmar KrappingerBurkhart Huber
Apr 19, 2015·Journal of Orthopaedic Surgery and Research·Peng YinPeifu Tang
Sep 8, 2015·BMC Musculoskeletal Disorders·Peng YinPeifu Tang
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Jun 3, 2015·The Bone & Joint Journal·D BoseM McNally
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