A prospective analysis of bony union and functional outcome of transosseous osteosynthesis with ilizarov external ring fixation system in infected nonunionfracture tibia

Amarnath, S (2012) A prospective analysis of bony union and functional outcome of transosseous osteosynthesis with ilizarov external ring fixation system in infected nonunionfracture tibia. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.

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Abstract

Infected nonunion has been defined as “a state of failure of union and persistence of infection at the fracture site for 6 to 8 months”. Long standing infected non-union and gap non-union is difficult to treat and is a challenging problem for the orthopaedicians. The problems associated with infected nonunion are multiple discharging sinuses, soft tissue loss, chronic osteomyelitis, osteopenia, joint stiffness, contractures, complex deformities, limb-length discrepancy, and multidrug resistance of the micro-organisms. A well-aligned, painless, healed and functional limb is the goal of treatment which is achieved by adequate and complete debridement, stable fracture stabilization, good soft tissue coverage and reconstruction of the bony defect. We have done a prospective analysis of Transosseous osteosynthesis with Ilizarov external ring fixation system in cases of infected nonunion fractue Tibia with a sample size of 20 patients, either with or without active infection. Of the analysed 20 patients, the mean follow-up of the patients was 7 months. The longest follow-up being 17 months and the shortest being 5 months. The average time period for achievement for solid bone in our study is about 160 days. This method helped us in the control of infection, to achieve solid bone union and to attain a good functional outcome. The patients were analysed for bony union and functional outcome based on the ASAMI scoring system. In our study “A PROSPECTIVE ANALYSIS OF BONY UNION AND FUNCTIONAL OUTCOME OF TRANSOSSEOUS OSTEOSYNTHESIS WITH ILIZAROV EXTERNAL RING FIXATION SYSTEM IN INFECTED NONUNION FRACTURE TIBIA” , 10 patients had excellent and 6 had good bony union. 12 patients had excellent and 4 patients had a good functional outcome according to the ASAMI scoring system. The Ilizarov ring fixator gives an option of compression, distraction and bone transport, and is effective in the treatment of infected nonunion fracture Tibia, where other types of treatment have failed . Ilizarov method is a minimally invasive, cheaper, versatile, cosmetic and 360 degree stable method. Early weight bearing is the key factor that distinguishes it from other conventional methods of fixation infected non-union Tibia. It promotes early functional recovery, eliminating fracture disease. Weight bearing and the functioning of the joints while on the treatment is an advantage of this technique. In the present scenario, the best available solution for management of infected nonunion of fracture Tibia associated with bone defects, limb length discrepancies, deformities is the Ilizarov ring fixation system. Transosseous osteosynthesis with Ilizarov ring fixation system is the safest, simplest, most economical and effective method for the management of infected nonunion fracture Tibia.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Infected nonunion of long bones, Fracture shaft of Tibia, Transosseous osteosynthesis, Ilizarov external ring fixation system, Distraction osteogenesis, Corticotomy and Bone transport, ASAMI scoring system.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 21 Sep 2017 02:05
Last Modified: 21 Sep 2017 02:05
URI: http://repository-tnmgrmu.ac.in/id/eprint/3024

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