Abstract
Infected nonunion is serious complication in the long bone fractures and it is sometimes resulted in significant disability.
From December 1990 to February 1994, we reviewed 11 cases who were treated for infected nonunion of the femur by using the Ilizarov apparatus at National Hedical Center, Active infection was controlled by radical resection of the infected necrotic bone and soft tissue and continuos irrigarion with antibiotics mixed saline for 3 weeks. After sequrstrectomy, bone deject was ranged from 2.5cm to 12.5cm(average, 7.2cm) in 11 cases. Preoperative leg length discrepancy(LLD) was ranged from 2.0cm to 8.Ocm(average, 3.9cm) in 7 of 11 cases. Bone defects were gradually treated by internal bone transport technique and solid bone union was achived by internal fixation and bone graft.
The average of transporation was 8.9cm(range, 2.5-15.5cm). The average of healing index was 1.6menths/cm(range, 1.0-3.6months/cm). The percentage of increment was ranged from 5% to 32%(average, 19.6%). According to Paleys classification, bony results was poor in 11 cases and functional results was good in four, fair in three, poor in four.
We concluded that the application of Illizarov technique to infected nonunion of the femur with large bone defect was useful method but internal fixation and bone graft was necessary for nonunion of doicking site.