Complex one-stage treatment of nonunion fractures, false joints and defects of long bones of the extremities complicated by osteomyelitis

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Abstract

The experience in complex one-step treatment of306patients with ununited fractures, pseudoarthrosis and defects of long bones as sequelae of traumatic (260 patients) and gunshot (46 patients) injuries complicated by osteomyelitis was presented. Complex treatment included radical fistulosequestrnecrectomy up to vast resection with simultaneous mono-, bi- or polyfocal osteosynthesis by pin-, rod or pin-rod external fixation devices; various types of dermatoplasty (when required); stimulation osteogenesis; general and local target antibacterial therapy; adequate postoperative drainage; correction of immune status and metabolic therapy; rehabilitation. That method enabled to decrease more than twice the rate ofpostoperative recurrent of osteomyelitic process; considerably decrease the duration and improve outcomes of treatment.

About the authors

Z. I. Urazgildeev

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, Moscow

O. M. Bushuev

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

A. S. Roskidailo

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

V. A. Lyalin

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

L. N. Furtseva

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

T. P. Gorokhov

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

R. Kumar

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

References

Supplementary files

Supplementary Files
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1. JATS XML
2. X-rays of the patient S., 51 years old. Gunshot comminuted fracture of the bones of the right leg, complicated by a purulent infection.a - before treatment; b — after resection sequestrectomy and corticotomy of the proximal fragment of the tibia; c — in the process of replacement of a tibial defect; d — before removal of the Ilizarov apparatus: the fracture of the tibia healed, the defect was replaced by a distraction regenerate; e - after dismantling the apparatus.

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