An outcome assessment of infected non-union of Tibia using Limb Reconstruction system (LRS)
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 10, Pages 4009-4016
AbstractBackground: Due to increasing number of high-energy traumatic events, the incidence of complex and compound fractures are also in the rise. Such fractures are often exposed to various environmental contaminants, inadequate debridement and sometimes erroneous decision making leading to cases of infected non unions. Eradication of infection in such cases and achieving union may sometimes pose serious challenge to orthopaedic surgeons. Presence of comminution, bone gap or deformity can seriously complicate the situation. No definite surgical technique has been found to be full proof in dealing with these infected nonunion cases.
Aim: The aim of the present study was to evaluate the functional and radiological outcome of Limb Reconstruction system (LRS) in infected nonunion of Tibia.
Materials and Methods: This prospective observational study was carried out in the Department of Orthopaedics, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India, for 1 year. We analysed 30 patients with infected non-union of tibial diaphysis treated by using the LRS after resection of infected and sclerotic bone at the fracture ends and doing bone transport from either end of tibia during this study period. Preoperative and monthly follow up post operative X-ray of the affected leg with AP and lateral view including knee and ankle joint were obtained and analysed till the completion of one year postoperatively. Results: The mean age 44.7yrs (25-60yrs), male: female ratio 2:1, average follow-up period 52.5 weeks, average bone resected 7.5 cm (4-14 cm), average duration of bone transport 10.7 weeks (5-19 weeks), an average union time of bone ends 10.9 weeks (8.8-11.9 weeks), average duration of consolidation of regenerate 38.2 weeks (32-42 weeks)of the patients. Bony results and functional results were assessed according to ASAMI Score. Bony results excellent – 73.33%, good-13.33%, fair – 6.67% and poor – 6.67%. Functional results were excellent – 53.33%, good- 23.33%, fair – 16.67% and poor – 6.67%. Out of 30 patient, 2 patient developed severe equinus deformity at ankle joint and 2 patient had limb length discrepancy >3.5 cm. 7 patient had superficial pin tract infection. Conclusion: LRS fixator is an excellent tool for management of infected non unions which is easy to apply, comfortable for the patient with minimum complications and predictable as well as reproducible outcomes.
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