Active treatment of segmental defects of long bones with established infection. A prospective study

Twenty-nine patients with chronically infected segmental defects of the tibia (15 cases), femur (7 cases), humerus (5 cases), and radius (2 cases) were treated during a six-year period (1975-1980). The defects were due to hematogenous osteomyelitis in six cases and trauma (vehicular accidents, crushing injuries, and gunshot wounds) in 23 cases. In 12 cases exposed bone was present owing to soft tissue and skin losses. Treatment consisting of stabilization of the fragments, thorough debridement, continuous irrigation, and cancellous bone grafting allowed early mobilization and achieved bony union with control of infection in all cases. Good to fair functional results were obtained in 22 of the 29 involved extremities.