To determine the outcome of septic non-union of tibia using compression and distraction technique with Ilizarov circular fixator in terms of infection free solid union.
Patients and Methods
This descriptive study was performed on 16 patients in Orthopaedic and Trauma Unit, Khyber Teaching Hospital, Peshawar and Khyber Medical Center, Peshawar, Pakistan from June, 2008 to June, 2011. Patients of either gender with age more than 15 years with supple knee and ankle joints having septic non-union of tibia were included in the study. Those with age below 14 years and having associated comorbidities like diabetes mellitus and immuno-insufficiency etc. which can compound the infective non-union in these patients and patients with poor vascular status of the affected lower limb and those requiring myocutaneous flap for coverage of wounds were excluded from the study. These patients were followed for two years. Outcome was recorded in terms of infection free union of the tibia at the septic non-union site radiographically and clinically during follow up visits and at time of removal of fixator.
Out of16 patients, 14 (87.5%) were male and 2 (12.5%) were female. Mean age was 33.4 years (range 23-55). Right tibia was affected in 10 patients (62.5%) and left in 6 patients (37.5%). The cause was road traffic accident in 12 patients (75%), fire arm injuries in 2 patients (12.5%) and fall in 2 patients (12.5%). Mean external fixator duration was 6.2 months. Results were graded as excellent in 9 patients (52.2%), good in 4 patients (25%) and fair in 3 patients (18.7%). The complication rate per patient was 1.3%.
By using the distraction and compression technique with ilizarov external fixator, it is possible to avoid infection and achieve solid union in resistant and infected cases of non-union of the diaphyseal region of tibia. (Rawal Med J 2012;37:332-337).
Key words: Septic non-union of tibia, Ilizarov, circular external fixator.