Tibial infected nonunions treated with radical debridement and Ilizarov tibial intercalary bone transport

Fifteen patients with tibial infected nonunions were managed with a two-stage treatment protocol, comprising a radical debridement and antibiotic PMMA beads implantation in the first stage and Ilizarov intercalary bone transport in the second stage. All the infections were eradicated and all the bone defects were successfully reconstructed by this treatment protocol. There was no recurrence of infection during a two to four years follow-up period (average, 2.9 years). The average length of regenerative gain in the tibial intercalary bone transport was 4.3 cm (range, 2 to 7 cm) and the average length of time in the Ilizarov apparatus was 9.5 months (range, 5 to 13 months). Three patients had delayed union which required additional cancellous bone grafting. Pin-site infection occurred in six patients. Two patients experienced knee flexion contractures and one patient experienced equinovarus contracture during treatment. The authors conclude that the Ilizarov intercalary bone transport is a useful method for the reconstruction of a debrided tibial bone defect.