Outcome of Ilizarov ring fixator for infected non-union of tibia in Udonthani Hospital
Keywords:
Ilizarov ring fixator, Infected non-union of bone, bone defectAbstract
Objective: The treatment for infected non-union of tibia is sequestrectomy and monofocal compression with Ilizarov ring external fixator in case without tibia defect. If large tibia defect present, the treatment is bifocal compression-distraction with Ilizarov ring fixator for regenerate bone and correct deformity. However the infected non-union of tibia is difficult to treatment and have spent a lot of time to effective result, and Ilizarov ring fixator technique have never been to study of outcome in General hospital before. The study design is retrospective study for assess the effectiveness of Ilizarov ring fixator in infected non-union of tibia in Udonthani hospital.
Method: Eleven patients (10 Male: 1 Female) Average age 34.8 years old (SD 17.58), who had an infected non-union of tibia between July 2013 - June 2017 at Udonthani hospital and treated with the Ilizarov technique, the main outcome was measured include Bone/Radiological and Functional outcomes assessed by the Association for the study and Application of Methods of Ilizarov (ASAMI) criteria and post removed Ilizarov ring fixator pain assessment when weight bearing by Numeric rating scale (NRS). The statistical analysis was performed using t-test for mean, standard deviation and using descriptive analysis for percentage.
Result: Ten from eleven patients had bone defect and average of bone defect length is 71.10 mm. (SD 33.51). All 11 patients had united bone and average united time is 251.45 days (SD 97.06). According to the ASAMI score for bone/radiological result are 8 were classed as excellent, 3 as good. Functional result found 4 classified as excellent, 6 as good, and only one patient as fair. Average pain assessment by NRS post removed Ilizarov ring fixator is 1.27 (SD 0.97).
Conclusion: We conclude that debridement combined with Ilizarov ring fixator is reliable method of treatment of infected non-union of tibia. The ASAMI score in this study are comparable with the other published literature though long bone defects.
References
2. Phieffer LS, Goulet JA (2006) Delayed unionof tibia (Instructional course lecture). J Bone Joint Surg Am. 88-A , 205-16.
3. Ilizarov GA, Deviator AA, Trokhova VG. Surgical lengthening of the shortened lower extremities. VestnKhirIm II Grek. 1972; 108(2): 100-3.
4. Ring D, Jupiter JB, Gan BS, Israeli R, Yaremchuk MJ. Infected non-union of tibia. Clin Orthop Relat Res 1999; (369): 302-11.
5. Association for the study and application of the methods of ilizarov group (1991) nonunion of the femur, in operative principles of ilizarov fracture treatment, nonunion, osteomyelitis, lengthening, deformity corrections. Maiocchi AB, Aronson J, Editors. Baltimore: Williams and Wilkins; 245-62.
6. Gustilo RB, Anderson JT. Prevention of infection in the treatment of 1025 open fracture of long bones: retrospective and prospective analyses. J Bone Joint Surg AM 1976; 58(4): 453-458
7. Naveed Bashir Wani, Basit Syed. Ilizarov ring fixator in the management of infected non-unions of tibia. SICOT J 2015; 1:22.
8. S. Patil, MBBS, MRCSEd, Clinical research fellow; and R Montgomery, FRCSEd, Consultant Orthopedic Surgeon. Management of complex tibia and femoral nonunion using the ilizarov technique, and its cost implications. J Bone Joint Surg Br 2006; 88(7): 928-32.
9. Dendrinos GK, Kontos S, Lyritsis E. Use of the Ilizarov technique for treatment of non-union of the tibia associated with infection. J Bone Joint Surg Am 1995; 77(6): 835-46.
10. Mohammad Shahid, Abid Hussian, Phillipa Bridgeman, Deepa Bose. Clinical Outcomes of the Ilizarov Method After an Infected Tibial Non Union. Arch Trauma Res 2003; 2(2): 71-5.
11. Higgins TF, Klatt JB, Beals TC. Lower extremity Assessment Project (LEAP) the best available evidence on limb threatening lower extremity trauma. OrthopClin North Am 2010; 41(2): 233-9.
Downloads
Published
How to Cite
Issue
Section
License
การละเมิดลิขสิทธิ์ถือเป็นความรับผิดชอบของผู้ส่งบทความโดยตรง
ผลงานที่ได้รับการตีพิมพ์ถือเป็นลิขสิทธิ์ของผู้นิพนธ์ ขอสงวนสิทธิ์มิให้นำเนื้อหา ทัศนะ หรือข้อคิดเห็นใด ๆ ของบทความในวารสารไปเผยแพร่ทางการค้าก่อนได้รับอนุญาตจากกองบรรณาธิการ อย่างเป็นลายลักษณ์อักษร
