Infected subtrochanteric nonunions of femur - Managed by Ilizarov method

Abstract

Background: The management of infected subtrochanteric femoral nonunions is a difficult clinical challenge to the reconstructive surgeon. We analyzed the results of infected subtrochanteric nonunions managed by the Ilizarov method. Materials and Methods: We present a 11-year prospective study of 14 consecutive infected subtrochanteric nonunions treated by the Ilizarov method between 2008 and 2018. The mean age of patients was 45.5 years (range 20–64). All were postoperative infections. The mean shortening of the femur in ten patients was 2.9 cm (range 2–7 cm). Implant removal was done in 12 cases. Wound debridement followed by Ilizarov fixation was done in the same sitting in all the patients except two, where a two-stage procedure was performed. A temporary external fixator was used for two-stage procedure. Long Schanz pins (cephalic pins) were effectively used for improved stability of the proximal fragment. Results: Thirteen of the 14 patients united. Infection was eradicated in thirteen of the fourteen patients. Mean fixator duration was 12.4 months (range 9.5–18) mean range of preserved knee motion was 95°, including two patients who had total knee stiffness. Conclusion: Ilizarov fixation is a reliable method to achieve union in infected subtrochanteric nonunion of femur.

Keywords

• femur
• ilizarov method
• infected
• subtrochanteric nonunion