Long-term outcome of Ilizarove treatment for infected tibial nonunion

Ununited fracture of tibia complicated by infection is not only a complex surgical problem but also a chronic and debilitating condition for patient and time-consuming problem for physician. Although traditional management results with success at times, it seems with Ilizarove external ring fixator we could achieve excellent results. From 1997 to 2004 these authors managed 84 patients with infected tibial nonunion in three teaching hospitals in Mashhad. There were 68 males and 16 females, with an average age of 26±8 years (17 to 55 years). The average time of follow-up was 3.5 years (range 3-9 year). In 81 (96.42%) patients we achieved union and eradication of infection. The average time in frame was 6.4 months. Three patients (3.42%) eventually underwent below knee amputation because of refractory and persistent infection or other problems. We faced pin tract infection and loosening in 18 patients for 41 pins. We had 10 patients (11.9%) with neuropraxia of the proneal never which improved simultaneously but no long standing neurologic deficit. Only one patient with false aneurysm of anterior tibial artery happened which underwent vascular surgery. The most common long standing morbidity following this treatment was foot and ankle stiffness and deformity especially in distal third cases. The Ilizarove technique for complex infected nonunion of tibia has a high rate of success in achieving union and eradication of infection. It is the only way, which we can advice the patient to be treated successfully strongly and surely.