Complications and Functional Outcome in Patients with Limb Reconstruction System: An Institutional Based Study
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 5
Abstract
Introduction: Complex non-union cases, that involves attempting limb reconstruction in the presence of bone loss and infection involves surgery which is technically demanding, time consuming for the surgeon and physically and psychologically demanding for the patient with no guarantee of a satisfactory outcome. Even after prolonged treatment and repeated surgeries outcome is unsure and amputation may be the only option left at last. Hence, present study is undertaken to evaluate union rates with rail fixator in the treatment of complex non-union of long bones and to study the complications associated with this treatment modality. Materials and Methods: The current clinical prospective study was conducted among 42 patients with complex non-union having infection at the site of non-union or a bone defect of more than 4 cm or cases with an attempt to achieve union that failed to heal after at least one supplementary intervention. Fixation was performed using a monolateral external fixator (Rail External Fixator System). Complications were classified according to the Paley classification as problem, obstacle, or true complication (minor or major). Results were calculated and graded as excellent, good, fair and poor based on ASAMI Scoring System. Results: Results were calculated according to ASAMI scoring system. Bone results were excellent in 12 (54.5%), good in 4 (18.18%), fair in 3 (13.6%) and poor in 3 (13.6%) cases. Functional results were excellent in 10 (45.45%), good in 5 (22.72%), fair in 4 (18.18%). Three cases were declared failure. Pin tract infection was the most common complication. Other complications encountered were pain during distraction, pin loosening, joint stiffness. There was no significant angular deviation (>15 degree) in any case. Neurovascular complications, joint subluxation or fracture of regenerate was not seen in any of the cases. Conclusion: We are of the opinion that in badly infected wound with bone loss and in cases where extensive soft tissue damage is there, rail fixator is a good choice to save the limb, to achieve union and to restore limb length. Successful treatment depends on proper wound care instructions, active participation, and careful monitoring. Collaboration with a physiotherapist is also important.
Authors and Affiliations
Ritesh Kumar, Awadhesh Bhati, Vinod Kumar Anand
Keywords
Related Articles
- EP ID EP536607
- DOI 10.21276/ijmrp.2018.4.5.004
- Views 61
- Downloads 0
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