DOI: 10.36347/sajb.2017.v05i10.004

Pages: 713-719

Infective nonunions of tibia are a surgical challenge in view of their compromised bone vascularity and are prone to limb shortening when treated by conventional methods. In this prospective case series done between July 2015 to June 2017, we treated 22 patients, reporting with infective non-union of tibia by the application of Ilizarov ring fixator. Surgical management of infective non-unions has drastically changed in the last two decades. The ring fixation device offers acute docking of the fracture non-union site and maintains compression, meanwhile any shortening that might have occurred due to either towards loss of communited fracture fragments or that lost during freshening of fracture non-union site can be addressed simultaneously by doing a corticotomy and bone transport simultaneously as the non-unions progresses successfully to union. An additional benefit of the ring fixation device used to treat these non-unions is that patients can resume ambulatory status as early as within 2 weeks from the date of surgery and can remain ambulant throughout the treatment time. If meticulous care of the pin tracts are taken care of, then ring fixation devices could be a gold standard in the treatment of infective non unions of tibia. The consolidation time in our series was anywhere between 6 months to 9 months depending upon the length of transport needed to compensate for limb shortening. All 22 cases went on to successful union. We had 40.5% of minor complications and 13.5 % of major complications. Hence our study concludes that the ilizarov ring fixator system is a versatile tool to surgically address infective tibial non- unions with or without bone length shortening. Subject to bone loss within 7.5cm.