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KMID : 0386420140270040301
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Journal of the Korean Fracture Society
2014 Volume.27 No. 4 p.301 ~ p.307
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The Efficacy of Preserved Posterior Cortex in the Treatment of Infected Nonunion of the Tibia
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Kim Hyoung-Min
Park Il-Jung
Roh Youn-Tae
Kang Byung-Min
Lee Hyun-Jin
Lee Jae-Young
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Abstract
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Purpose: We studied the efficacy of preserved posterior cortex connecting to adjacent muscle or periosteum during wide debridement in the treatment of infected nonunion of the tibia.
Materials and Methods: From January 2001 to May 2011, 12 cases of infected nonunion of the tibia with segmental defect larger than 4 cm after wide debridement were selected. The selected cases were categorized according to two groups; group 1 with preserved posterior cortex in the segmental defect site - six cases, group 2 without posterior cortex - six cases. The results were compared by assessing the size of bone defect, the interval between wide debridement and bone reconstruction, bony union time, complications, and clinical results.
Results: The mean length of bone defect of group 1 was 7.6 cm (range 4.3-11.0 cm) and that of group 2 was 6.4 cm (range 4.0-12.0 cm). The interval between wide debridement and bone reconstruction was 10.0 weeks (range 5-18 weeks) for group 1, and 12.1 weeks (range 0-24 weeks) for group 2. The time for bony union of group 1 was 6.2 months (range 5-7 months), and that of group 2 was 10.8 months (range 7-18 months). In group 2, there were two cases of fatigue fracture and two cases of docking site nonunion after distraction osteogenesis.
Conclusion: The preserved posterior cortex after wide debridement of infected nonunion of the tibia helps bony union and reduces the treatment period.
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KEYWORD
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Tibia, Infected nonunion, Posterior cortex
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