Limb salvage and functional recovery in infected nonunion of the distal tibia treated with the Ilizarov techniques

IntroductionTreatment of infected nonunion the distal juxta-articular tibia is a challenge due to short fragment, deformity, thin soft-tissue envelope, and active infection. There still no consensus on approach that able maximally salvage limb ankle function.Material methodsInfected was managed with two Ilizarov techniques, monofocal compression (MC) used in 12 patients bifocal compression-distraction (BCD) 6 patients. The choice technique depended size postresection defect, ≥3 cm or ≤3 cm, respectively. tactics functional were careful debridement, insertion wires fragment so they do not penetrate joint, stable fixation, temporary bridging forefoot. MSCT along regular radiography assess union regeneration. Ankle functions evaluated AOFAS ankle-hindfoot score system.ResultsBone consolidation, infection arrest function improvement achieved all External fixation continued 221.7 ± 15.1 days for MC 235 25.8 BCD. Complications wound divergence, wire-tract infection, premature consolidation fibula, hypoplastic regeneration one case. mean after treatment 90.7 2.5 points 89.7 1.3 BCD Residual discrepancy ranged 0–4 cm. Bone shortening compensated patients.ConclusionLimb-salvage techniques achieves good outcomes. It provides bone arrest, defect compensation significantly improves joint function.