Ilizarov Method in Treatment of Tibial and Femoral Infected Non-unions in Pateitnes with High-energy Trauma and Battle-field Wounds

This study was performed to evaluate the results of 14 years of application of Ilizarov method in treatment of infected non-unions of tibia and femur in patients with severe trauma and battlefield wounds. Seventeen patients with long bone nonunion (14 were with infected nonunion of tibia out of whom two were associated with tibial bone defects and 3 with infected non-union of femur) were admitted for the study. After preliminary debridement (in infected cases with draining fistulae) and preparation for external fixation, ring fixator was introduced and compression alone or compression and distraction (in atrophic non-unions) were enforced on fragments to induce union. Bone transfer was used in cases with bone defects. All cases resulted in complete union and had infection controlled. The mean time of union was 8 months in tibial infected non-unions and 10 months in infected femoral nonunions. In cases with bone defects, the mean union time was 12 months. In selected cases of infected tibial and femoral non-union, Ilizarov is an efficient method of treatment, especially with bone transfer in cases with bone defects. The application of this method in battle-field wounds has resulted in noticeable outcomes. Patient’s tolerance was low in cases of femoral Ilizarov, but this is the method of choice for tibial infected non-unions, taking into account the lack of the need for long-term antibiotic use. Acta Medica Iranica, 42(5): 343-349; 2004