Outcome of complex non-unions of femoral fractures managed with Ilizarov method of distraction osteogenesis

OBJECTIVE: To evaluate the management outcome of complex non-union of femoral fractures with Ilizarov method in terms of bone union, functional results and any complications. METHODS: This case series study was carried out at the Departments of Orthopedic Surgery, National Institute of Rehabilitation Medicine (NIRM), Islamabad and Civil hospital, Quetta over a period of three and half years, January 1, 2015 to June 30,2018. RESULTS: There were 50 patients in the study. There were 48(96%) males and 2(4%) females. The ages ranged between 17-54 years with a mean of 33.58±8.9 years. As per ASAMI criteria, the bone results were excellent in 17(34%), good in 30(60%), fair in 1(2%) and poor in 2(4%) patients. The functional results were excellent in 15(30%), good in 24(48%), fair in 8(16%) and poor in 3(6%). The bone union rate was 98% whereas infection eradication rate was 94%. The most frequent complications were pin tract infection affecting 80% patients, knee stiffness 60% patients and K-wires loosening 20% patients. CONCLUSION: The Ilizarov method provides an effective solution to address the complex non-union of femur fractures. It helps to ensure fracture healing, eradicates infection and provides good functional outcome. The attended complications are mild to moderate and manageable with conservative means.