From November 1990 to May 1992, 25 patients aged from 20 to 58 years were treated for infected bone loss with soft tissue defect and shortening by the Ilizarov technique. A total of 25 segments were treated in the tibia (19), femur (4) and
forearm
(2).
The causes were open comminuted fractures with initial bone loss(3) and bone defect after removal of sequestrum (22). Infection was managed by radical resection of the infected necrotic bone and insertion of gentamycin-cement beads. Bony defects
were
gradually closed by the Ilizarov's internal bone transport technique, and final equalization of leg length inequality was achieved by means of external lengthening technique. The initial bony defect averaged 7.2cm in length, which was treated by
distraction osteogenesis by 16.3% lengthening of the initial bone length (range, 14.2%-31%). Tibial corticotomies were performed at the proximal level alone(14), at the distal level alone (9), and at the double levels (2). The average healing
index
was
45.9 days/cm(proximal, 44.3 days/cm; distal, 47.5days/cm; double levels, 34.5 dyas/cm). The complications included delayed union (3), severe pin tract infection (3), mild flexion contracture of knee(2) and intractable pain (1). At an average 15
months
follow up, according to Paley and Catagni's classification4) bony and functional results were either excellent or good in all cases. We conclude that Ilizarov technique is very effective for treatment of infected open fracture with bone loss,
limb
shortening, and soft tissue defect.
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