Experience in fixation of infected non-union tibia by Ilizarov technique - a retrospective study of 42 cases☆

Meleppuram, Jimmy Joseph; Ibrahim, Syed

doi:10.1016/j.rboe.2016.11.008

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Revista Brasileira de Ortopedia

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ORIGINAL ARTICLE • Rev. bras. ortop. 52 (06) • Nov-Dec 2017 • https://doi.org/10.1016/j.rboe.2016.11.008 copy

Experience in fixation of infected non-union tibia by Ilizarov technique - a retrospective study of 42 cases^☆ ☆ Work performed in the Vinayaka Missions Medical College and Hospital, Department of Orthopaedics, Pondy, India.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

The aim of the study is to evaluate the clinical and functional outcome in treatment of infected tibial nonunion by the Ilizarov method.

METHODS:

The authors retrospectively analyzed 42 patients with infected tibial nonunion with bone loss; shortening and deformity treated at this institution during the period of February 2012 to April 2015 were included in the study. The results were evaluated according to Association for the Study and Application of the Methods of Ilizarov (ASAMI) criteria. Pin tract infections were assessed by Moore and Dahl score.

RESULTS:

Bone results were excellent in 60% of patients (n = 25), good in 15% (n = 6), fair in 25% (n = 11), and poor in none. The functional results were excellent in 55% of patients, good in 30%, fair in 5%, and poor in 10%. The most common complication found in this study was pin tract infection.

CONCLUSION:

Ilizarov ring fixator still remains an excellent treatment modality for tibial nonunion, as it addresses the problems associated with the condition, although the procedure is cumbersome.

Keywords:
Tibia; Ilizarov technique; Infection; External fixators

Results	Excellent	Good	Fair	Poor
Paley¹⁵	60.87%	26.09%	8.7%	4.35%
Madhusudhan et al.¹⁶	22%	36.34%	22%	18.18%
Dendrinos et al.¹¹	50%	29%	3.6%	17.4%
Lalit et al.¹⁷	70%	10%	0%	20%
Present study	60%	15%	25%	0%

Results	Excellent	Good	Fair	Poor
Paley¹⁵	64%	28%	4%	4%
Madhusudhan et al.¹⁶	5.56%	22.22%	33.33%	38.89%
Dendrinos et al.¹¹	25%	39.2%	14.3%	2.15%
Lalit et al.¹⁷	26.7%	40%	10%	28.3%
Present study	55%	30%	5%	10%

Grade	Inflammation
0	None or marginal
1	Marginal inflammation
2	Inflamed – serous
3	Inflamed – purulent
4	Inflamed with induration – seropurulent
5	Inflamed with induration, tenderness, surrounding erythema – gross purulent

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author. E-mail: jimmyjoseph939@gmail.com (J.J. Meleppuram).

Type I	Fragments in apposition with mild infection and with or without implant
Type II	Fragments in apposition with severe infection with large or small wound
Type III IIIa IIIb IIIc	Severe infection with a gap or deformity or shortening Defect with loss of full circumference Defect in >1/3rd of cortex Infected non-union with deformity

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Experience in fixation of infected non-union tibia by Ilizarov technique - a retrospective study of 42 cases☆ ☆ Work performed in the Vinayaka Missions Medical College and Hospital, Department of Orthopaedics, Pondy, India.

ABSTRACT

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Experience in fixation of infected non-union tibia by Ilizarov technique - a retrospective study of 42 cases^☆ ☆ Work performed in the Vinayaka Missions Medical College and Hospital, Department of Orthopaedics, Pondy, India.