Abstract
Thirty patients of infected nonunion of long bones were treated with radical resection of the necrotic bone and bone transport or compression/distraction osteosynthesis. Nonunion, infection, deformity, bone gap and shortening were all addressed simultaneously using the Ilizarov principles. There were 15 cases with bone loss ranging from 4 to 12cm (median bone gap of 7 cm), 10 cases of stiff non-union (6 of which had an associated deformity) and 5 cases of mobile non-union. The median time in Ilizarov frame was 150 days. Median follow up after frame removal was 33.5 months. Bone grafting at docking site was required in only 3 cases(10%). There were 3 cases of refracture(10%) and 3 cases of recurrence of infection (10%). The bone result was excellent in 21 patients (70%), good in 3(10%), fair in none (0%) and poor in 6 (20%). The functional results were excellent in 8 patients (26.7%), good in 12 (40%), fair in3 (10%) and poor in 7 (23.3%). It is difficult to precisely define the indications for preservation and reconstruction of severe injuries. The surgical team has to appreciate the length, disability, complications and cost of treatment. Patients must be aware of the limitations of functional results and the possible difficulty of return to work despite the reconstructive attempt.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
