Peculiarities of metal-osteosynthesis in un united fractures and pseudoarthroses of lower extremities complicated by purulent infection

The experience treatment in 123 patients with un united diaphyseal fractures and pseudoarthroses of the crus (93 patients) and femur (30 patients) complicated by purulent infection is presented. Term after trauma ranged from 2 months to 12 years. Readmission treatment failed. Contractures, marked trophic disturbances, muscular at rophy were detected in almost all patients. Closed trans- osseous osteosynthesis using external fixation device was performed in 12 patients. One hundred eleven patients underwent one-stage operation including radical fistulosequester-necrectomy, when indicated or vast segmental sequestrnecrectomy and transosseous osteosynthesis by external fixation device with pins, rods or their combina tion. The pattern of osteosynthesis depended on the volume of bone defect formed after sequestrnectomy: monolacal osteosynthesis was used when the defect was up to 4 cm, bilocal osteosynthesis in 5-8 cm defect and polyfocal osteosynthesis when defect was over 8 cm. In one-stage treatment 96% of patients had positive out comes: elimination of osteomyelitis, bone healing and restoration of the extremity length. Treatment duration was 1.5-2 times shorter in comparison with routine treatment methods.