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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Ilizarov external fixation and then nailing in management of infected nonunions of the tibial shaft
Journal of Trauma - Injury, Infection and Critical Care, Volume 65, No. 3, Year 2008
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Description
Background:: Ilizarov technique is useful in the management of infected nonunions of the tibia. Its main drawback is the long duration of external fixation (EF) with marked patient discomfort. Several techniques have been described for early removal of EF to avoid this problem. Methods:: Between September 2000 and October 2001, a prospective study at a tertiary trauma center was performed. Thirty-three patients with infected nonunion of the tibial shaft were included. The eradication of infection was by debridement, followed by limb reconstruction using segment transport technique with Ilizarov EF system. When the transported segment reached the docking site, we offered the patients removal of EF, and replacement by intramedullary (I M) fixation with bone graft at the docking site. Advantages and risks were explained to all patients. Patients (N = 17) who accepted this technique were compared with patients (N = 16) who preferred to continue in EF till full bone union, with bone graft at the docking site used in both groups. Mean age of the patients was 29 years, and mean duration of nonunion was 12.6 (range, 6-22) months. Average duration of follow-up from the date of presentation was 36 (range, 22-48) months. Main outcome measurements were assessment of bone and functional outcome using the classification of the association for the study and application of the method of ilizarov, ef index, radiographic consolidation index, healing time, duration of ef, and complications results:: The average duration of EF in the first group was 3.1 month, meanwhile in the second group it was 8.5 months. The Association for the Study and Application of the Method of Ilizarov bony and functional outcome assessment score showed no statistically significant difference between the two techniques on follow-up. Conclusion:: Early removal of EF and replacement by intramedullary nail can achieve complete healing for infected nonunion of the tibial shaft with shorter duration of EF; nearly one-third the usual duration of EF and give the same functional and bony outcome as the classic technique. It is a relatively safe technique but the risk of infection recurrence must be explained to the patient. © 2008 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Emara, K.
Egypt, Cairo
Faculty of Medicine - Ain Shams University
Allam, Mohamed F.
Egypt, Cairo
Faculty of Medicine - Ain Shams University
Statistics
Citations: 50
Authors: 2
Affiliations: 1
Identifiers
Doi:
10.1097/TA.0b013e3181569ecc
ISSN:
00225282
e-ISSN:
15298809
Research Areas
Health System And Policy
Study Design
Cohort Study