Management of Infected Non-United Femoral Fractures by Ilizarov Ring Fixator

Aim: The aim of this prospective study is to evaluate the Ilizarov external fixator system as a method of fixation for infected non-united fractures of the femur following debridement of the fracture site. Materials and Methods: 18 patients presenting with infected nonunited femoral fractures were treated by extensive debridement and external fixation using Ilizarov external fixator. (16 male+2 females) with a mean age of 27.4 (18- 45). All patients had infected nonunitcd femoral fractures without bone or soft tissue loss with chronic infection persistent for more than 6 months. The causative trauma was motor vehicle accidents in all cases. All cases were initially managed by internal fixation with a mean number of previous surgical procedures of 5.1 operations (1-9) in the form of repeated debridement, revision of fixation and bone grafting. The mean duration of application of the fixator was 8. 9 months (6-12). Weight bearing was permitted immediately postoperative. 6 patients required iliac crest bone graft to achieve solid union. Results: Resolution of infection was achieved in all patients, union was achieved in 15 patients, and the remaining 3 patients required further management. The most common complications were pin tract infection, loosening and fracture mal alignment that necessitated exchanging of loose pins and readjustment. Conclusion: We concluded that Tlizarov external fixator offered a reliable and successful method for stabilization of infected nonunited fractures of the femur following extensive debridement that helps in the management of such difficult condition.