The The Evaluation of the Radiological and Functional Outcome of Distraction Osteogenesis in Patients with Infected Gap Nonunions of Tibia Treated by Bone Transport

Ayush Kumar Singh; Mangal Parihar; Syed Bokhari

doi:10.3889/oamjms.2019.112

Authors

Ayush Kumar Singh Lower Limb Fellow, Wrightington Hospital, United Kingdom
Mangal Parihar Grant Medical College, Mumbai, India
Syed Bokhari Lower Limb Fellow, Wrightington Hospital, United Kingdom

DOI:

https://doi.org/10.3889/oamjms.2019.112

Keywords:

Distraction Osteogenesis, Ilizarov, LRS, Non Union

Abstract

AIM: The aims of this investigation were: 1) to study the Functional outcome of performing distraction osteogenesis in cases of infected non-union of tibia treated with Ilizarov and Limb Reconstruction System, and 2) to study the Radiological outcome of performing distraction osteogenesis in cases of infected non-union of tibia treated with Ilizarov and Limb Reconstruction System.

METHODS: The study was done with 27 patients of infected gap nonunions of the tibia at Sir JJ Hospitals, Mumbai from 2013-2016. After implant removal, if required radical resection of necrotic tissue and fractures were stabilised with Ilizarov or mono-lateral fixator depending on non-union site. Corticotomy was either done proximally or distally. Patients were followed up at monthly intervals for a minimum of 6 months.

RESULTS: The ASAMI-Bone healing score was Excellent or Good in 86% patients, and Functional score was Excellent or Good in 89% of patients. The commonest problems were of pin tract infection, wire loosening and angulation of the transported segment.

CONCLUSION: Elderly age, persistent infection, sensory loss in the foot, the stiffness of the knee, and above all the patientâ€™s reluctance to go any further given the protracted treatment besides, systemic disorders such as diabetes are all pointers for considering amputation as an alternative.

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