Infected non-union of tibia treated with limb reconstruction system (LRS): A prospective study

Abstract

Introduction: Infected non-union of the tibia is difficult to manage due to problems like osteomyelitis, soft tissue distortion, draining sinuses, demineralization of bone, joint stiffness, and multidrug-resistant polybacterial infection. Material and Methods: We report the outcome of 18 patients (16 males and 2 females) of infected non-union tibia treated with the Limb reconstruction system. The causes were open fracture in 15 cases and infection following internal fixation in 3 cases. We assessed the limb reconstruction system in the management of infected non-union of the tibia in terms of, union rate, control of infection, and associated complications. The assessment parameters were based on the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria.Result:88% were male and 11% were female, mean age was 32 ±9. The mean bone gap was 3.1±1.0. Draining sinus was present in 10 (55.6%) of the patients. Corticotomy and fibula osteotomy was performed in 14 (77.8%) of the patients. Bony union was seen in 17 (94.4%) of the patients. The mean time of union was found to be 9.7±1.7 months. The mean limb length discrepancy was 1.1±0.6 cm. Deformity angle of less than 7 degrees was present in 16 (88.9%).15 (83.3%) patients had excellent ASAMI bone scores and the remaining 02 (11.1%) had a good score. One patient in which the union was not observed had a poor score. For the functional component, 12 (66.7%) had an excellent score, 05 (27.8%) had a good score and 01 (5.6%) with non-union of the tibia bone was found to have a poor score. Conclusion: Limb reconstruction system is easy to perform, has predictable healing for infected non-union, has a short learning curve, ensures compliance in patients, and provides reliable results with lesser complications