ABSTRACT
Background:
Nonunions of the distal femur fracture is an uncommon yet challenging complication. The current study aimed at presenting the radiographic and clinical outcomes after using the Ilizarov external fixation in the treatment of these nonunions.
Methods:
The current retrospective case series included 12 male patients with a mean age of 41.67 years with distal femur nonunion treated by Ilizarov fixator. The original fracture type was 33A2 (two cases), 33A3 (four cases) and 33C2 (six cases) based on AO/OTA system. Nine cases (75%) were infected and three (25%) were aseptic. The duration from the initial trauma till Ilizarov fixation averaged 15.42 months. Six cases had associated angular deformity. Assessment of the bone results and the functional results was performed according to the ASAMI criteria.
Results:
Time in the fixator averaged 163.75 days (Range 135- 190). The mean follow-up duration was 35.33 months (range, 24-48 months). All patients achieved complete union without major complications or deep infection. One case healed with a 7° valgus angulation. Two cases had residual shortening of 2.5 cm and 3 cm respectively. At the last follow-up, the knee range of motion averaged 72.5 degrees. The ASAMI bone result was good in these three cases (25%) and excellent in nine cases (75%). The ASAMI functional result was excellent in only two patients (16.7%), good in eight patients (66.7%), and fair in two (16.7%)
Conclusions:
The Ilizarov external fixation technique can be used as an effective treatment option with low complications in the management of nonunited distal femoral fractures that may be difficult to manage using other means of fixation.
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