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Srpski arhiv za celokupno lekarstvo 2012 Volume 140, Issue 1-2, Pages: 65-70
https://doi.org/10.2298/SARH1202065V
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Infected tibial nonunions: Treatment by the Ilizarov method - multicentric study

Vukašinović Zoran (Institut za ortopedsko-hirurške bolesti „Banjica”, Beograd + Medicinski fakultet, Beograd)
Spasovski Duško ORCID iD icon (Institut za ortopedsko-hirurške bolesti „Banjica”, Beograd + Medicinski fakultet, Beograd)
Vučetić Čedomir ORCID iD icon (Medicinski fakultet, Beograd + Klinika za ortopedsku hirurgiju i traumatologiju, Klinički centar Srbije, Beograd)
Jovanović Vesna (Institut za ortopedsko-hirurške bolesti „Banjica”, Beograd)
Šešlija Igor (Klinike i bolničke službe Foča, Klinički centar, Istočno Sarajevo, Bosna i Hercegovina;)
Živković Zorica ORCID iD icon (Kliničko-bolnički centar „Dr Dragiša Mišović”, Beograd + Medicinska akademija US Medical School, Evropski univerzitet, Beograd)

Introduction. Associated bone tissue defect and infection, commonly result in non-healing, i.e. by the development of infected tibial nonunion. Objective. The aim of the paper was to present experiences acquired in the treatment of this problem by the application of the Ilizarov method. Methods. The analyses enrolled 16 patients diagnosed with infected tibial nonunion. The Ilizarov method was used in all the patients, of type bilocal synchronous compressive-distractive or bilocal alternating compressive-distractive. Bone and functional results were classified as excellent, good, fair and poor. Total follow-up period of the patients was 48.77±41.57 months on the average. Results. Fifteen (93.75%) cases of nonunions were successfully healed. According to the laboratory findings of inflammation, the same patients were also successfully treated for local infection. The inequality of the lower limbs was also resolved by new bone formation of average length of 5.75±3.29 cm. Poor result was verified in one (6.25%) patient only. The patient satisfaction was scored 3.73±1.33 and physician’s satisfaction 4.33±1.11. Conclusion. The Ilizarov method with bone transport, because of being capable to solve simultaneously a local infection and tibial malalignement, and by substituting bone and soft tissue defects, thus enabling healing of until then unhealed bone, has shown as the best method in the treatment of this complex problem, infected tibial nonunions.

Keywords: tibia, infected nonunion, Ilizarov method