Assessing the outcomes of treatment of infected long bone nonunion fracture with distraction osteogenesis using the linear rail system

Abstract

Background: The treatment of bone gap due to an infected nonunion and open infected fracture is very interesting and controversial topic in orthopedics due to factors such as poor vascularity of surrounding tissue. Distraction osteogenesis is a method of producing unlimited quantities of living bone directly from a special osteotomy site. This study was performed to assess the role of bone transport by rail fixator (Pitkar, India) in treatment of bone gap in long bones due to infected long bones nonunion fracture. Methods: Patients folders were perused, proforma formed and data collected partly from the folder and partly filled by the enrollee. Information as regards biodata, clinicoradiological characteristics, Outcome of management were taken. Patient also filled the quality of life questionnaire. Data analyzed using SPSS version 23 and represented as charts and tables. Variables were compared and conclusions drawn'. Results: 85.7% were males. M:F ratio 6:1. Ages 32-40 were the most operated (50%). Limb lengthening was done in 53.6% while bone transport in 39.3%.the tibia was the bone most operated in 85.7% of cases. Most distractions were less than 7cm (50%). Pin tract infection was the most common problem found in 5 out of the 28enrollees, most had no problems. Limb length discrepancy was found in 7.1%. There were associations found between complication and aim of surgery and also with length gained. Conclusion:The linear rail system is vasatile in the treatment of infected long bone nonunion fractures with excellent result, little complications and a very satisfactory quality of life.