title: Complications associated with distraction osteogenesis for infected nonunion of the femoral shaft in the presence of a bone defect: a retrospective series.
abstract: We undertook a retrospective study of 50 consecutive patients (41 male, 9 female) with an infected nonunion and bone defect of the femoral shaft who had been treated by radical debridement and distraction osteogenesis. Their mean age was 29.9 years (9 to 58) and they had a mean of 3.8 (2 to 19) previous operations. They were followed for a mean of 5.9 years (2.0 to 19.0). The mean duration of the distraction osteogenesis was 24.5 months (2 to 39). Pin-track infection was observed in all patients. The range of knee movement was reduced and there was a mean residual leg-length discrepancy of 1.9 cm (0 to 8) after treatment. One patient required hip disarticulation to manage intractable sepsis. In all, 13 patients had persistent pain. Bony union was achieved in 49 patients at a mean of 20.7 months (12 to 35). Although distraction osteogenesis is commonly used for the treatment of infected femoral nonunion with bone defects, it is associated with a high rate of complications.
authors.affiliation: Department of Orthopaedics and Traumatology, Federal University, Rua Borges Lagoa, São Paulo, Brazil.
authors.forename: A L L
authors.initials: AL
authors.lastname: Blum
authors.forename: J C
authors.initials: JC
authors.lastname: BongioVanni
authors.forename: S J
authors.initials: SJ
authors.lastname: Morgan
authors.forename: M A
authors.initials: MA
authors.lastname: Flierl
authors.forename: F Baldy
authors.initials: FB
authors.lastname: dos Reis
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003646:Debridement / Q000009:adverse effects / Q000379:methods; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000009:adverse effects* / Q000379:methods; D010019:Osteomyelitis / Q000601:surgery; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult