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Abstract
There are many difficult problems in the treatment of inferted nonunions of the femur, e.g, eradication of infection and osseous union even in the presence of devastating infection. To solve these diffcult problems, various methods were tried including thorugh debridement and rigid internal nxation or external fixation, and bone graft.
Recently, large bone defect due to resection of infected bone was treated excellently using llizarov external fixator. Authors treated 13 cases of infected nonunions of femur with Ilizarov external fixator from september 1989 to July 1994.
The results were as follows.
1. Among 13 cases of infected nonunion of femoral fracture, 1 case was treated with internal fixation and others with external fixation, and obtaned bone union in all cases.
2. Mean number of previous surgery in other hospital was 3.2(1-5) times and mean number of surgery in our hospital was 2.5(1-5) times.
3. Lengthening(including length of internal bone transport) was performed from 2.5cm to 22cm.
4. Duration of treatment was from 4 months to 27 months(Mean : 11 months). In conclusion, infected femoral nonunion in very selective cases could be treated with retention of internal fixation (Exchange of nail, or plate and screws). But converison to external fixator should be well prepared in most cases.
Infected nonunion could be managed in staged surgery with use of modular external fixator like llizarov external fixator. Management of infection, malposition, and shortening could be controlled more safely and more definitely with the ring external fixator.
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