Treatment of infected juxtaarticular nonunion of proximal tibia with complex deformity by ilizarov technique

Abstract

Infective nonunions of juxtaarticular proximal tibia are one of the most difficult orthopaedic problems. There are very few studies in English literature describing the management of juxtaarticular proximal tibial infective nonunions. They are usually associated with soft tissue problems and complex deformities. We present 22 years old male patient with proximal tibia infective nonunion associated with discharging sinus, adherent skin and complex deformity, who underwent gradual deformity correction just distal to nonunion site followed by compression at nonunion by Ilizarov methodology. It is a novel technique to treat juxtaarticular proximal tibial infective nonunion along with deformity correction, which avoids the probable complications like loss of soft tissue coverage and articular cartilage damage associated with radical debridement of nonunion site. At six months follow up his limb was well aligned with radiological evidence of union. At four year follow up patient was free from pain, deformity and infection.