J Korean Orthop Assoc.  2008 Oct;43(5):610-617. 10.4055/jkoa.2008.43.5.610.

The Treatment of Infected Nonunions of Femur using Sequestrectomy and Distraction Osteogenesis

• Jung ST
• Jeong KC
• Kim HJ
• Kim KH
• Lee JH
• Choi MS

• KMID: 2186423
• DOI: http://doi.org/10.4055/jkoa.2008.43.5.610

Abstract

PURPOSE: From this study we are to know the result of distraction osteogenesis for infected nonunions of femur using sequestrectomy and Ilizarov external fixator.
MATERIALS AND METHODS
17 patients who had distraction osteogenesis using external fixator and also had more than 2.5 cm bone loss after sequestrectomy for having infected nonunions of femur from 1991 to 2005. Their average age was 32.4 (range, 10-60) years and mean follow up period was 22 (range, 14-36) months. We used Healing index as an index for bone formation. The results were divided into bone results and functional results and analyzed by grading. Also we estimated the complication according to the Paley's classification.
RESULTS
After seqestrectomy, bone defect was ranged from 5cm to 13 cm (average, 7.3 cm) and The average of transportation was 5.8 cm (range, 3-10 cm). HI was 47.4 (27.17-65.80) days/cm. Solid bony union occurred in the all cases after surgery but, 4 cases needed bone graft at docking site. According to the final examination there were 2 cases with leg-length discrepancy that is bigger than 2.5 cm and the average size of was 1.0 cm.
CONCLUSION
We consider distraction osteogenesis using Ilizarov external fixator as useful method to restore bone loss caused after sequestrectomy for infected nonunions of femur.

Keyword

Femur; Infected nonunion; Sequestrectomy; Distraction osteogenesis; Ilizarov external fixator

MeSH Terms

External Fixators
Femur
Follow-Up Studies
Humans
Osteogenesis
Osteogenesis, Distraction
Transplants
Transportation