The Treatment of Infected Defect of Long Bone By Internal Lengthening with Ilizarov Apparatus

Bone defect of the long bone while perhaps less common today than in the past, continues to challange orthopaedic surgeons. It is usually very diffcult to obtain union and to correct coexisting deformity, infection and leg length discrepancy. In more complex cases with atrophic bone ends, substance defects, chronic osteomyelitis, or combination of these, amputation may be the eventual outcome despite current techniques of internal fixation, bone grafting and electrical stimulation. External fixation has recently gained popularity as a multifactorial approach to the management of infected non-union. We used internal legthening technique with Ilizarov apparatus for the infected large bone defect of long bone to achieve union, to correct deformity, to eradicate infection, to reestablish limb length and to eliminate bone defect. Five patients aged from 17 to 47 years ( average 30.8 yrs) were treated for infected large bone defect of long bone. All had chronic osteomyelitis at the bone defect area. Bone defects were closed from within without bone grafts by the Ilizarov bone transport technique of sliding bone fragment internally. The average bone defect size was 4.6 Cm. The defect was restored completely by internal lengthening, deformity was corrected by means of hinges of apparatus. Infection was treated by radical resection of the necrotic bone combined with muscle pedicled graft to cover the skin defect. The average duration of lengthening was 52 days. Healing index of the lengthening site was checked. So, we concluded that Ilizarov technique can be used for the bone defect with infection, leg length discrepancy and deformity, to close the bone defect to eradicate bone infection and to correct deformity, simultaneously.