Management of Complex Non Union in Long Bones with Limb Reconstruction System (Rail Fixator) Application
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 4
Abstract
Introduction: Nonunion is complete suspension of the process of union because of arrest of the repair process and radiological or clinical evidence of healing has not been seen for months. There is still controversy regarding union rates and complications associated with rail fixator. So this study has been done to assess the union rates, infection control and complications associated with the device. Materials and Methods: The present prospective clinical study has been conducted on 42 patients with complex non-union of long bones managed with application of rail fixators. Fixation was performed using a monolateral external fixator. A single- level corticotomy and distraction was performed through healthy tissue when the gap or shortening was more than 2 cm. Patients were followed up regularly in OPD every two weeks for the first two months and thereafter every month till docking of the fracture fragments was achieved. Results: Majority of the patients had an external fixator or infected implant at the time of presentation. No special investigations were required in our study except for frequent X-Rays and pus culture and sensitivity. Corticotomy was done in almost half (55%) of the patients. Two patients required additional bone grafting and one patient required freshening of bone ends as secondary procedures. Another secondary procedure adopted was PRPP injection in 1 patient at the docking site to achieve union but it ultimately failed to unite Out of 42 patients treatment has been completed in 22 patients while remaining 18 patients are still undergoing treatment and one patient lost to follow up. Mean treatment duration was 7.9 months ranging from 4 months to 14 months. Conclusion: In conclusion, complex nonunion can be managed satisfactorily with rail fixators. It is a good alternative to Ilizarov fixation in management of complex nonunion of long bones. An active involvement and participation of the patients is necessary for successful treatment by rail fixator.
Authors and Affiliations
Vinod Kumar Anand, Awadhesh Bhati, Ritesh Kumar
Keywords
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- EP ID EP535509
- DOI 10.21276/ijmrp.2018.4.4.059
- Views 70
- Downloads 0
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