[EFFECTIVENESS OF Ilizarov TECHNOLOGY FOR INFECTED FOREARM NONUNION]

To explore the effectiveness and method of Ilizarov technology for the treatment of infected forearm nonunion.

Between January 2004 and March 2014, 19 patients with infected forearm nonunion were treated, including 12 males and 7 females with a mean age of 37.4 years (range, 18-62 years). The injury causes included traffic accident in 11 patients, falling from height in 4 patients, and machine twist injury in 4 patients. The patients had received surgical treatment for 1-5 times (mean, 2.7 times). Bone defects located at the radius in 10 cases, at the ulna in 7 cases, and at the radius and ulna in 2 cases. The mean time of chronic infection was 8.3 months (range, 4-16 months). The mean length of the bone defects after debridement was 3.54 cm (range, 2.2-7.5 cm). Under the guidance of C-arm fluoroscope, the Orthofix unilateral external fixator was used to fix. Distraction was performed at 7-10 days after operation, and X-ray film was taken regularly to detect the osteogenesis.

The mean external fixation time was 6.5 months (range, 3-12 months), and the mean external fixation index was 1.72 months/cm (range, 1.14-2.15 months/cm). All patients were followed up for 35.4 months on average (range, 24-55 months). The bone union time was 3-11 months (mean, 6 months); and no recurrence of infection was observed. At last follow-up, the mean wrist range of motion (ROM) were 52.78° (range, 42-55°) in flexion and 46.53° (range, 40-60°) in extension; the mean elbow ROM were 139.23° (range, 130-150°) in flexion and 3.57° (range, 0-20°) in extension; and the mean forearm ROM were 76.68° (range, 68-90°) in pronation and 81.75° (range, 72-90°) in supination.

Ilizarov technology for infected forearm nonunion can acquire satisfactory clinical results. Radical debridement is the key to control bone infection.