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  • Title: [Treatment of ununited fractures and pseudarthrosis of long bones of the lower limbs complicated by osteomyelitis].
    Author: Urazgil'deev ZI, Roskidaĭlo AS.
    Journal: Khirurgiia (Mosk); 1999; (9):48-54. PubMed ID: 10533372.
    Abstract:
    123 patients with ununited diaphyseal fractures and false joints of the shin bones (93) and the hip (30), complicated by purulent infection, were treated in the clinic for pyogenic complications and consequences of locomotor traumas of the CITO from 1988 to 1994 years. Most patients were men (110 patients). The posttraumatic period varied from several months to 12 years. Many patients before their admittance to the clinic were not once unsuccessfully operated 69 (56.1%) patients had osseous defects of the thigh and the shin, all patients contractures of joints of the lower extremities as well as substantial trophic disturbances and atrophy of the muscles. 12 patients underwent closed transosseous osteosynthesis by the apparatus of an external fixation. One stage surgery was carried out in 111 patients, which included radical fistulosequestrenecretomy (and when indicated--extended segmental sequestrectomy) and transosseous osteosynthesis by the apparatus of external fixation with the use of the needles, rods, or their combination. The feature of the osteosynthesis depended on the extent of bone defect, which has been developed after sequestrectomy, in the defect up to 4 cm monolocal osteosynthesis was used, in the defect from 5 to 8 cm--bilocal and if it were over 8 cm--multilocal osteosynthesis was preferable. One stage treatment resulted in favourable outcomes in 95.9% of patients: the osteomyelitis was eliminated, the integrity of the bone was restored and in a great majority of cases--the length of the extremity was preserved. The treatment duration was 1.5-2 times less than in commonly used methods.
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