Use of the limb reconstruction system for the management of non-union of the tibia: A prospective case series

Abstract

Introduction: Management of fracture non-unions of the tibia are demanding due to the hampered vascular supply, poor bone quality and the deficient soft tissue cover. Instead of the traditional Ilizarov’s ring fixator which is bulky, technically demanding and has a poor patient compliance, the Limb Reconstruction System (LRS) is a viable alternative. The aim of this study is to assess the functional and radiological outcome and the complications associated with the management of fracture non-union tibia treated with LRS. Method: A prospective case series was undertaken comprising of 20 patients. Both infected and non-infected shaft of tibia fractures were enrolled. Patients underwent debridement, implant removal and definitive fixation with LRS. Radiological and functional outcome were assessed using the ASAMI (Association for the Study and Application of the Method of Ilizarov Group) score. Results: In 90% cases the mechanism of injury was road traffic accident. Mean period of non-union before admission was 12.85 months, mean time for union was 9.30 months, with 95.0% cases successfully uniting. 55% cases underwent lengthening following Ilizarov’s principles. ASAMI Radiological outcome was Excellent in 80%, Good in 15% and Poor in 5% cases. ASAMI Functional outcome was Excellent in 40%, Good in 50% and Poor in 10% cases. Pin tract infection was the most common problem at 70.0% while ankle stiffness at 35% was the most common true complication. Conclusion: Thus by this study it can be expressed that LRS is a feasible alternative to ring fixators for the management of fracture non-union shaft of tibia.