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The Ilizarov method for complex fracture nonunions.

INTRODUCTION
Nonunion of complex fractures continues to challenge orthopedic trauma surgeons. Although traditional management results in a successful outcome in 50% to 80% of cases, the Ilizarov method has been reported to be more effective. We evaluated the efficacy of the Ilizarov method for treatment of nonunions.


METHODS
Patients were selected based on the presence of nonunion associated with osteomyelitis, treatment failure, or extensive segmental bone loss. Treatment principles include surgical debridement, stabilization, and bone regeneration for correction of defects. Patients were given maximum mobility and were required to function as normally as possible during the course of treatment.


RESULTS
Seventeen patients were treated for complex nonunions with the Ilizarov method during a 33-month period. Seven patients were facing the alternative of amputation. Causes of nonunion were osteomyelitis (65%), failure of conventional treatment (23%), and segmental bone loss (12%). Fractures involved the lower (82%) and upper (18%) extremities. Using the Ilizarov method, union was achieved in 94% (16 of 17) of patients over an average time of 6 months.


CONCLUSION
Our results indicate that the Ilizarov method is superior to traditional techniques of managing complex nonunions.