International Journal of Research in Orthopaedics | May-June 2024 | Vol 10 | Issue 3 Page 514
International Journal of Research in Orthopaedics
Hossain MZ et al. Int J Res Orthop. 2024 May;10(3):514-519
http://www.ijoro.org
Original Research Article
Complications of Ilizarov method treatment for infected nonunion
femoral shaft fracture
M. Zakir Hossain
1
*, Manash Chandra Sarker
1
, M. Jahangir Alam
2
, Naima Ferdousi
4
,
M. Abdul Gani Mollah
1
, Nazmul Huda Setu
1
, Raquib Mohammad Manzur
1
,
Devolina Bhowmik
3
INTRODUCTION
Infected nonunion of the femur is not uncommon in
clinical practice, but the treatment of this disease has been
a challenge for orthopedic surgeons.
1,2
Some related
factors usually complicate the infected non-union
including bone loss, deformities, limb-length inequalities,
and polybacterial infection.
3
Ilizarov's methods can
eliminate infection, recompense for bone defects, and
ABSTRACT
Background: Infected non-union of the femur is complicated by the involvement of soft tissue and bone, long-term
resistant multi-bacterial infection, limb length discrepancy, deformities, joint stiffness, and multiple draining sinuses,
and poses a challenge for orthopedic surgeons. This study aimed to analyze the complications of Ilizarov method
treatment for infected non-union femoral shaft fracture.
Methods: This prospective observational study was conducted at the national institute of traumatology and orthopedic
rehabilitation (NITOR), Dhaka, Bangladesh, from May 2018 to August 2020. A total of 20 patients were selected as
study subjects by purposive sampling technique. All data were collected using a pre-formed questionnaire. Data were
processed and analyzed using computer software program SPSS version 22.0.
Result: The mean bone gap created during the operation was 2.7±1.7 cm of them, in 12 (60%) patients, it was 0 to 2
cm, and in 8 (40%) patients it was more than 2 cm. The mean time needed for radiological union was 7.85±2.1 months
ranging from 5 months to 11 months. In 10 (50%) patients, union was achieved within 4 to 7 months, and in 10 (50%)
patients it was 8 to 11 months. Regarding limb length discrepancy, in 5 (25%) cases there was no limb length
discrepancy (LLD). Twelve patients had 1 cm to 2.4 cm LLD and 3 (15%) patients had ≥2.5 cm LLD. The mean LLD
was 1.2±0.9 cm. Regarding complications, in 10 (50%) cases, there was no complication and 10 (50%) patients had
complications. The complications were pin tract infection in 7 (35%) patients and wire loosening in 3 (15%) patients.
Conclusions: The study concludes that while the Ilizarov ring fixator proves to be a dependable and successful method
for stabilizing, correcting length discrepancies, and eliminating infections, it is not without its share of complications.
The findings of this research indicate a 50% complication rate among the patients undergoing this treatment.
Keywords: Femur, Ilizarov method, Infected, Non-union, Limb length discrepancy
1
Department of Orthopaedic, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka,
Bangladesh
2
Department of Orthopaedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR),
Dhaka, Bangladesh
3
Department of Microbiology, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka,
Bangladesh
Received: 05 February 2024
Revised: 07 March 2024
Accepted: 20 March 2024
*Correspondence:
Dr. M. Zakir Hossain,
E-mail: zakirnitor2@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20241101